Jennifer Leigh Destefano, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00058600 Issued in NJ

Practice address

230 West Parkway
Unit #10
Pompton Plains, NJ 07444

Phone

(973) 835-0800

Fax

(973) 616-2766

NPI assigned

Sep 5, 2008

Last updated

Sep 5, 2008By the provider in NPPES

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Emergency Physician Associates of North Jersey P C

  • Emergency Medicine Physician
  • Summit, NJ
  • NPI 1497783419
  Medicare reassignment
• Ariston Radiology Associates, L,L,C.

  • Radiation Oncology Physician
  • Totowa, NJ
  • NPI 1689844870
  NPD (past)
• Atlantic Professional Services of New Jersey, P.a.

  • Physician Assistant
  • Stratford, NJ
  • NPI 1932145182
  NPD (past)
• Montclair Anesthesia Associates, P.C.

  • Anesthesiology Physician
  • Montclair, NJ
  • NPI 1841245628
  NPD (past)

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

{
    "created_epoch": "1220572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220572800000",
    "number": "1528216389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 WEST PARKWAY",
            "address_2": "UNIT #10",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "07444",
            "telephone_number": "973-835-0800",
            "fax_number": "973-616-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 WEST PARKWAY",
            "address_2": "UNIT #10",
            "city": "POMPTON PLAINS",
            "state": "NJ",
            "postal_code": "07444",
            "telephone_number": "973-835-0800",
            "fax_number": "973-616-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "JENNIFER",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00058600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Degroot
• Harold Delaleu, M.D.
• Danielle Deleonardo, LMT
• Andrew Thomas Dellapi, MD
• John Demarco, M.ED., LPC
• Sonam Jay Dhiman, DO
• Teresa D Diaz
• Jeffrey Steven Dobro, M.D.
• Alyssa Anne Rowen Donnelly, M.A., CCC-SLP
• Lori Drenswick, OT

• Physician Assistant in Pompton Plains, NJ
• Providers in Pompton Plains, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.