Marissa Destefano, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

25MP00947700 Issued in NJ

Practice address

1941 Limestone Rd Ste 101
Wilmington, DE 19808-5413

Phone

(302) 655-9494

NPI assigned

Oct 25, 2024

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

Medicare fee-for-service enrollment

Enrolled in DE, NJ2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kennedy Medical Group Practice, P.C.Group PAC ID 2860616877, 417 clinicians

Regional Orthopaedic Associates PAGroup PAC ID 4880681485, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jefferson Stratford Hospital Hospital, Stratford, NJ, CCN 310086

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mdestefano@direct.delortho.com

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.

• Regional Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Wilmington, DE
  • NPI 1194735779

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Kennedy Medical Group Practice, P.C.

  • Family Medicine Physician
  • Voorhees, NJ
  • NPI 1952726796
  Medicare reassignment Care Compare group
• Regional Orthopaedic Associates PA

  • Orthopaedic Surgery Physician
  • Newark, DE
  • NPI 1700458874

  Physician Assistant

  NPD
• Kennedy Medical Group Practice P.C.

  • Family Medicine Physician
  • Turnersville, NJ
  • NPI 1881987337
  NPD
• Kennedy Medical Group Practice PC

  • Family Medicine Physician
  • Sewell, NJ
  • NPI 1952848905
  NPD

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

• Kennedy University Hospital Inc.

  • General Acute Care Hospital
  • Stratford, NJ
  • NPI 1386746592
  Care Compare affiliation

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

{
    "created_epoch": "1729814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757462400000",
    "number": "1750103479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 PATURA RD",
            "city": "MODENA",
            "state": "NY",
            "postal_code": "125485310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1941 LIMESTONE RD STE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198085413",
            "telephone_number": "302-655-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "MARISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-25",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00947700",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "DE",
            "license": "C5-0012164",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumera B Desilva, PHARM D
• Joseph Desimone Jr.
• Erin Desmond, PT, DPT
• Peter M Desroches, PTA
• Falon Desselle, LCSW
• John William Dettwyler, PH.D.
• Johanna Foster Detwiler, PA-C
• Charlene Miltz Deuber, APRN
• Ellen S. Deutsch, MD
• Stephanie Anne Deutsch, M.D.

• Surgical Physician Assistant in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Surgical Physician Assistant in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.