Individual provider Active NPI

Gina Louise Destefano, OD

  • Optometrist
  • Plainville, MA
National Provider Identifier
1770314726
Registry record updated Jun 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
OPT8361 Issued in MA
Practice address
51 Man Mar Dr Unit 2
Plainville, MA 02762-2272
Phone
(508) 222-9914
Fax
(508) 222-9914
NPI assigned
Aug 12, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X OPT8361 MA Primary
Optometrist 152W00000X 011050 NY

Addresses

Primary practice location

51 Man Mar Dr Unit 2
Plainville, MA 02762-2272

Mailing address

1797 Washington St
Holliston, MA 01746-2239
Phone (774) 573-6307

Other practice location 1

2875 Broadway
New York, NY 10025-7846
Phone (929) 822-4165

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

51 Man Mar Dr
Plainville, MA 02762-2272

51 Man Mar Dr
Unit 2
Plainville, MA 02762-2266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011050NYMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sabrina Gaan OD LLC Optometrist CurrentSince Jul 2, 2019 Accepting new patients

Locations

367 Washington St
Boston, MA 02108
Phone (617) 542-9221

51 Man Mar Dr
Unit 2
Plainville, MA 02762
Phone (508) 222-9912

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781136000000",
    "number": "1770314726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1797 WASHINGTON ST",
            "city": "HOLLISTON",
            "state": "MA",
            "postal_code": "017462239",
            "telephone_number": "774-573-6307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 MAN MAR DR UNIT 2",
            "city": "PLAINVILLE",
            "state": "MA",
            "postal_code": "027622272",
            "telephone_number": "508-222-9914",
            "fax_number": "508-222-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2875 Broadway",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100257846",
            "country_code": "US",
            "telephone_number": "929-822-4165",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DESTEFANO",
        "first_name": "GINA",
        "middle_name": "LOUISE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-12",
        "last_updated": "2026-06-11",
        "certification_date": "2026-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MA",
            "license": "OPT8361",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "011050",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plainville, MA

Sources for this page

Verify at the official NPI Registry.