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ALISON DESTEFANO MS, CCC-SLP
NPI 1104404623
Speech-Language Pathologist in Medford, MA

Active since March 29, 2021
619 BOSTON AVE APT 1, MEDFORD, MA 02155(781) 572-4555(855) 232-8604 Get Directions Write a Review

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Alison Destefano Ms, Ccc-slp NPPES

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

ALISON DESTEFANO MS, CCC-SLP (NPI 1104404623) is an individual speech-language pathologist provider in Medford, Massachusetts, licensed in Massachusetts (76791) and active in the NPI registry since March 2021.

NPPES Registry Identity

NPI1104404623
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameALISON DESTEFANOCredential: MS, CCC-SLP
Location Address619 BOSTON AVE APT 1Medford, MA 02155-1375
Mailing Address619 Boston Ave Apt 1Medford, MA 02155-1375 · (781) 572-4555 · Fax (855) 232-8604
Phone(781) 572-4555
Fax(855) 232-8604
Sole ProprietorNo
Enumeration DateMarch 29, 2021
NPPES CertifiedMarch 29, 2021
✔ NPI 1104404623 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MA · 76791
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
619 BOSTON AVE APT 1, Medford, MA 02155
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alison Destefano Ms, Ccc-slp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Alison Destefano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Functional Pathways Preferred Of Tennessee LLC
828 mi
Physical Therapist
10133 SHERRILL BLVD, SUITE 200
Knoxville, TN 37932
  • Reassigned Medicare billing, Massachusetts enrollment
  • 14 clinicians in this Medicare group
NPI 1841561446 (888) 531-2204

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Alison Destefano's NPI number?

The NPI number for Alison Destefano is 1104404623. It was assigned to this individual provider in the NPPES registry on March 29, 2021.

Where is Alison Destefano located?

Alison Destefano practices at 619 Boston Ave Apt 1, Medford, MA 02155. The listed phone number is (781) 572-4555.

What is Alison Destefano's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

Is Alison Destefano enrolled in Medicare?

Yes. Alison Destefano is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Alison Destefano's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Alison Destefano reassigns Medicare benefits to Functional Pathways Preferred Of Tennessee LLC (Knoxville, TN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Alison Destefano's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Alison Destefano was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.