Ericka Marie Distefano, FNP, ACUPUNCTURIST

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704293102 Issued in MI

Practice address

301 Explorer St
Gwinn, MI 49841-2813

Phone

(906) 346-9275

Fax

(906) 372-3230

NPI assigned

Jun 29, 2021

Last updated

Feb 28, 2022By 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 MI

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

DLP Marquette Physician Practices IncGroup PAC ID 9931359601, 193 clinicians

Upper Great Lakes Family Health CenterGroup PAC ID 1951432384, 41 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Uphs Marquette DLP Hospital Hospital, Marquette, MI, CCN 230054
• Bell Hospital Hospital, Ishpeming, MI, CCN 231321
• Up Health System Portage Hospital, Hancock, MI, CCN 230108
• Schoolcraft Memorial Hospital Hospital, Manistique, MI, CCN 231303
• Baraga County Memorial Hospital Hospital, L' Anse, MI, CCN 231307

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ericka.distefano.2@8233.direct.athenahealth.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.

• DLP Marquette Physician Practices Inc

  dba Marquette General Family Medicine - Marquette

  • Obesity Medicine (Internal Medicine) Physician
  • Marquette, MI
  • NPI 1487902995
  Medicare reassignment Care Compare group NPD
• Upper Great Lakes Family Health Center

  dba Sawyer Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Gwinn, MI
  • NPI 1700103777
  Medicare reassignment Care Compare group NPD
• Bell Physician Practices Inc

  • Family Medicine Physician
  • Ishpeming, MI
  • NPI 1578992491
  Medicare reassignment NPD
• Bell Physician Practices Inc

  dba UP Medical Group - Bell Women's Care

  • Rural Health Clinic/Center
  • Ishpeming, MI
  • NPI 1114726676
  NPD
• DLP Marquette Physician Practices Inc

  dba UP Health System Pediatric Specialists

  • Rural Health Clinic/Center
  • Marquette, MI
  • NPI 1205635760
  NPD
• Upper Great Lakes Family Health Center

  dba Upper Great Lakes Family Health Mobile Unit 1

  • Federally Qualified Health Center (FQHC)
  • Laurium, MI
  • NPI 1114788619
  NPD
• Upper Great Lakes Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Hancock, MI
  • NPI 1255755757
  NPD
• DLP Marquette Physician Practices Inc

  dba Marquette General Emergency Medicine

  • Emergency Medicine Physician
  • Marquette, MI
  • NPI 1366790727
  NPD (past)
• Upper Great Lakes Family Health Center

  dba Gwinn Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Gwinn, MI
  • NPI 1104158690
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Acquisition Bell Hospital LLC

  dba UP Health System Bell

  • Critical Access Hospital
  • Ishpeming, MI
  • NPI 1699101345
  Care Compare affiliation
• Baraga County Memorial Hospital

  • Critical Access Hospital
  • L'Anse, MI
  • NPI 1558479824
  Care Compare affiliation
• DLP Marquette General Hospital LLC

  dba UP Health System Marquette

  • General Acute Care Hospital
  • Marquette, MI
  • NPI 1568727048
  Care Compare affiliation
• Portage Hospital LLC

  dba UP Health System Portage

  • General Acute Care Hospital
  • Hancock, MI
  • NPI 1245667229
  Care Compare affiliation
• Schoolcraft Memorial Hospital

  • Critical Access Hospital
  • Manistique, MI
  • NPI 1700805157
  Care Compare affiliation

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1639749963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 EXPLORER ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498412813",
            "telephone_number": "906-346-9275",
            "fax_number": "906-372-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 EXPLORER ST",
            "city": "GWINN",
            "state": "MI",
            "postal_code": "498412813",
            "telephone_number": "906-346-9275",
            "fax_number": "906-372-3230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "135 E M35",
            "address_purpose": "LOCATION",
            "city": "Gwinn",
            "state": "MI",
            "postal_code": "498419160",
            "country_code": "US",
            "telephone_number": "906-346-9275",
            "fax_number": "906-372-3230",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DISTEFANO",
        "first_name": "ERICKA",
        "middle_name": "MARIE",
        "credential": "FNP, ACUPUNCTURIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-29",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704293102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine a Kroll, DO,PC
• Lisenia Collazo, DMD
• Theodore W Collins, D.O.
• Ashley E Croasdell, FNP
• Sandra Croasdell, FNP-BC
• Andrew James Ekdahl, D.D.S.
• Collene Nicole Froberg, D.C.
• Garrett H Green, LPC
• Gwendolyn Buck DDS PLLC (Northern Trails Dental Care)
• Gwendolyn Buck DDS PLLC

• Family Nurse Practitioner in Gwinn, MI
• Providers in Gwinn, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; 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.