John Distasio, M.A., ED., S.A.S.

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

638857951 Issued in NY

Practice address

6 E 85TH St
New York, NY 10028-0419

Phone

(212) 249-3806

Fax

(212) 249-3786

NPI assigned

Mar 25, 2019

Last updated

Mar 25, 2019By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553472000000",
    "number": "1649730631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E 85TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280419",
            "telephone_number": "212-249-3806",
            "fax_number": "212-249-3786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E 85TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100280419",
            "telephone_number": "212-249-3806",
            "fax_number": "212-249-3786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DISTASIO",
        "first_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "M.A., ED., S.A.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2019-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "638857951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Jane Dispenziere, LCSW
• Zachary Francis Dispirito, DDS
• Aimee Dispoto, PSY.D.
• Ayelet Dissen, PA
• Elaine G Distasi, MSW, LCSW
• Alberto Giuseppe Distefano, M.D.
• Alessandra Teresa Distefano, PA-C
• Douglas Craig Distefano, M.D.
• Janet A Distefano, R.PH.
• Michele Distefano, MS, CCC/A

• Behavior Analyst in New York, NY
• Providers in New York, NY by specialty
• Behavior Analyst in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2019; 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.