Michael Charles Distefano, MD

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

MA04126600 Issued in NJ

Practice address

140 Route 17 North
Suite 255
Paramus, NJ 07652

Phone

(201) 261-5501

Fax

(201) 261-3350

NPI assigned

Jun 28, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Michael Distefano, M.D., P.a.

  • Orthopaedic Surgery Physician
  • Paramus, NJ
  • NPI 1477736270
  Authorized official Same address or phone
• Orthopedic Specialist of New Jersey PA

  • Orthopaedic Surgery Physician
  • Hackensack, NJ
  • NPI 1326229840
  NPD

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1407883887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 ROUTE 17 NORTH",
            "address_2": "SUITE 255",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-261-5501",
            "fax_number": "201-261-3350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ROUTE 17 NORTH",
            "address_2": "SUITE 255",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "07652",
            "telephone_number": "201-261-5501",
            "fax_number": "201-261-3350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NJ",
            "license": "MA04126600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa Jennifer Didomenico, LPC
• Difelice Orthopaedics PC
• Susan Digiorgio-Gentile, N.P.
• Direct Meds Paramus Inc
• Discovery Practice Management, Inc. (Center for Discovery, Paramus)
• Divine Care Health Staffing LLC
• Melissa Nicole Divney, LSW
• Simona Dlabal, AGNP-BC
• Emily Dodd, PT, DPT
• Chris Patrick Doerr, APN

• Orthopaedic Surgery Physician in Paramus, NJ
• Providers in Paramus, NJ by specialty
• Orthopaedic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.