Elizabeth Noel Distefano, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

2045-IOD Issued in WV

Practice address

42 McGinnis Dr
Wayne, WV 25570-9553

Phone

(304) 272-5136

Fax

(304) 272-6261

NPI assigned

Aug 14, 2011

Last updated

May 28, 2024By 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 2

Addresses

Other names 1

• Elizabeth Noel Randolph Former name

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Indiana University - School of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Valley Health Systems, IncGroup PAC ID 9931017969, shared by 41 NPIs, 110 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: edistefano20046@valleyhealthsystems.direct-ci.com

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.

• Valley Health Systems Inc

  dba Valley Health East Huntington Health Center

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1720333461

  Optometrist

  Medicare reassignment NPD
• Valley Health Systems Inc

  dba Valley Health Highlawn

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1902962368
  Medicare reassignment NPD
• Valley Health Systems, Inc.

  dba Valley Health - Milton at Harbour Way

  • Federally Qualified Health Center (FQHC)
  • Milton, WV
  • NPI 1376276931

  Optometrist

  Medicare reassignment NPD
• Valley Health Systems, Inc

  dba Valley Health Wayne

  • Federally Qualified Health Center (FQHC)
  • Wayne, WV
  • NPI 1528038577
  NPD
• Valley Health Systems, Inc.

  • Federally Qualified Health Center (FQHC)
  • Huntington, WV
  • NPI 1508720913
  NPD
• Valley Health Systems Inc

  dba Grant Medical Center

  • Family Medicine Physician
  • Milton, WV
  • NPI 1891775557
  NPD (past)
• America's Best Contacts & Eyeglasses

  • Optician
  • Danville, VA
  • NPI 1154684496
  NPD (past)

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

{
    "created_epoch": "1313280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1639458276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2585 3RD AVE",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257031642",
            "telephone_number": "304-697-1396",
            "fax_number": "304-697-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 MCGINNIS DR",
            "city": "WAYNE",
            "state": "WV",
            "postal_code": "255709553",
            "telephone_number": "304-272-5136",
            "fax_number": "304-272-6261"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "145 Holt Garrison Pkwy",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245405958",
            "country_code": "US",
            "telephone_number": "434-483-2199",
            "fax_number": "434-710-4910",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "85 Donohoe Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257058887",
            "country_code": "US",
            "telephone_number": "304-399-3310",
            "fax_number": "304-523-5416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "ELIZABETH",
        "middle_name": "NOEL",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-14",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002273",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "WV",
            "license": "2045-IOD",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "RANDOLPH",
            "middle_name": "NOEL",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Optometrist in Wayne, WV
• Providers in Wayne, WV by specialty
• Optometrist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.