Active NPI
Jennifer Destefano, NP-C
- Family Nurse Practitioner
- Grosse Pointe, MI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704282745
- Practice address
- 468 Cadieux Rd
Grosse Pointe, MI 48230-1507 - Phone
- (313) 473-1000
- NPI assigned
- Sep 9, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704282745 | MI | Primary |
Addresses
Primary practice location
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Mailing address
2879 Roundtree Dr
Troy, MI 48083-2331
Phone (586) 604-0465
Other names 1
- Jennifer Bezrutch
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jbezrutch16185@direct.beaumont.edu |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161005002435 | MI | Practitioner - Nurse Practitioner | 0042508194 | Reassigns benefits to 2 organizations |
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
28100 Grand River Ave
Farmington Hills, MI 48336-5970
468 Cadieux Rd
Grosse Pointe, MI 48230-1507
Phone (313) 473-1705
Hospital & facility affiliations
- Beaumont Hospital - Grosse Pointe
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.37 of 100
- Quality
- 66.73
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 70.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704282745 | MI | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Beaumont Medical Group Hospital -Based Services | Current | Accepting new patients | |
| Beaumont Medical Group- Specialty Services | Current | Accepting new patients |
Locations
28100 Grand River Ave
Ste 301
Farmington Hills, MI 48336
Phone (947) 521-1320
468 Cadieux Rd
Grosse Pt Wds, MI 48230
Phone (313) 343-1000
44201 Dequindre Rd
Troy, MI 48085
Phone (248) 471-8255
Interoperability endpoints
- jdestefano1458869@epic00.shdirect.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Hospitalist Physician
- Royal Oak, MI
- NPI 1427567858
MI
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1720535552",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2879 ROUNDTREE DR",
"city": "TROY",
"state": "MI",
"postal_code": "480832331",
"telephone_number": "586-604-0465"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "468 CADIEUX RD",
"city": "GROSSE POINTE",
"state": "MI",
"postal_code": "482301507",
"telephone_number": "313-473-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DESTEFANO",
"first_name": "JENNIFER",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-09",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704282745",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jbezrutch16185@direct.beaumont.edu",
"affiliation": "N",
"address_1": "468 Cadieux Rd",
"city": "Grosse Pointe",
"state": "MI",
"country_code": "US",
"postal_code": "482301507",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "BEZRUTCH",
"credential": "NP",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Grosse Pointe, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; 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.