Paul Distefano, MS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

700 Lac de Ville Blvd
Rochester, NY 14618-5665

Phone

(585) 385-6287

NPI assigned

Dec 17, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Daystar for Medically Fragile Children, Inc

  • Early Intervention Provider Agency
  • Rochester, NY
  • NPI 1508250267
  NPD
• Daystar Formedically Fragile Children, Inc

  • Child Physical Disabilities Respite Care
  • Rochester, NY
  • NPI 1376935957
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396405338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHELMSFORD RD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146181757",
            "telephone_number": "585-733-2980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 LAC DE VILLE BLVD",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146185665",
            "telephone_number": "585-385-6287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "PAUL",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-12-17",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Discoveries Counseling and Wellness Center
• Korinne Marie Diss, MD
• Wimal Samarasinghe Dissanayake, MD
• Wendy Distasio
• Allison G Distefano, MS
• Joseph Anthony Ditursi, MD
• Tiera Divers
• Diverse Mosaic Community Center Inc
• Diversified Dental Service
• Caitlyn Divincenzo, NP

• School Psychologist in Rochester, NY
• Providers in Rochester, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.