DAVID ANTHONY DISTEFANO MD
NPI 1083173082
Orthopaedic Surgery - Sports Medicine in Syracuse, NY

Q: What is David Distefano's NPI number?

The NPI number for David Distefano is 1083173082. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Q: What is David Distefano's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Q: When was this NPI record last updated?

The NPPES record for David Distefano was last updated on August 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 19, 2019PECOS EnrolledAccepts Medicare Assignment

5719 WIDEWATERS PKWY, SYRACUSE, NY 13214(315) 251-3100(315) 449-9923 Get Directions Write a Review

NPPES record last updated: August 16, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 16, 2025, Feb 4, 2025, Jul 19, 2024 and 1 more (4 updates tracked since 2019).

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About David Anthony Distefano Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DAVID ANTHONY DISTEFANO MD (NPI 1083173082) is an individual sports medicine provider in Syracuse, New York, licensed in New York (338689) and active in the NPI registry since March 2019. He is enrolled in Medicare PECOS, is affiliated with St Joseph's Hospital Health Center, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1083173082

Entity TypeIndividualMale

Primary Taxonomy207XX0005X

Provider Legal NameDAVID ANTHONY DISTEFANOCredential: MD

Location Address5719 WIDEWATERS PKWYSyracuse, NY 13214-1985

Mailing AddressPo Box 580Syracuse, NY 13214-0580 · (315) 251-3140 · Fax (315) 552-6046

Phone(315) 251-3100

Fax(315) 449-9923

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateMarch 19, 2019

Last NPPES UpdateAugust 16, 20254 updates tracked since enumeration

NPPES CertifiedAugust 16, 2025

✔ NPI 1083173082 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207XX0005X

License✔ Licensed in NY · 338689

Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.

5719 WIDEWATERS PKWY, Syracuse, NY 13214

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

David Anthony Distefano Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3678993722

PECOS Enrollment IDI20250908004141

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph's Hospital Health Center

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330140

Location301 Prospect AvenueSyracuse, NY 13203 · Onondaga County

Emergency services Birthing friendly

Crouse Hospital

Acute Care Hospitals · Syracuse, NY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330203

Location736 Irving AvenueSyracuse, NY 13210 · Onondaga County

Emergency services Birthing friendly

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE HARTENSTEIN P.T.

Physical Therapist

5719 WIDEWATERS PKWY
DE WITT, NY 13214

Onondaga County (315) 449-1301

MATTHEW D HOOD P.A.

Physician Assistant (Surgical)

5719 WIDEWATERS PKWY
SYRACUSE, NY 13214

Onondaga County (315) 251-3100

JAMES WAYNE HILL RPAC

Physician Assistant

5719 WIDEWATERS PKWY
SYRACUSE, NY 13214

Onondaga County (315) 251-3100

MELISSA R BUTLER NP

Nurse Practitioner (Adult Health)

5719 WIDEWATERS PKWY
SYRACUSE, NY 13214

Onondaga County (315) 251-3100

MR. MATTHEW JOSEPH SWEET MS, ATC

Specialist/Technologist (Athletic Trainer)

5719 WIDEWATERS PKWY
SYRACUSE, NY 13214

Onondaga County (315) 449-1301

DR. JOHN J CAMBARERI M.D.

Orthopaedic Surgery

5719 WIDEWATERS PKWY
DE WITT, NY 13214

Onondaga County (315) 251-3100

JUNE LEO-RANDAZZO O.T.

Occupational Therapist

5719 WIDEWATERS PKWY
DE WITT, NY 13214

Onondaga County (315) 449-1301

VINCENT MARINO JR. P.T.

Physical Therapist

5719 WIDEWATERS PKWY
DE WITT, NY 13214

Onondaga County (315) 449-1301

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is David Distefano's NPI number?

The NPI number for David Distefano is 1083173082. It was assigned to this individual provider in the NPPES registry on March 19, 2019.

Where is David Distefano located?

David Distefano practices at 5719 Widewaters Pkwy, Syracuse, NY 13214. The listed phone number is (315) 251-3100.

What is David Distefano's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is David Distefano enrolled in Medicare?

Yes. David Distefano is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does David Distefano accept?

Health plans from Medica list David Distefano as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is David Distefano affiliated with any hospitals?

According to CMS data, David Distefano is affiliated with St Joseph's Hospital Health Center and Crouse Hospital.

When was this NPI record last updated?

The NPPES record for David Distefano was last updated on August 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.