Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

ELISE K DISTEFANO PA-C
NPI 1104659713
Physician Assistant in Farmington, MO

Q: What is Elise Distefano's NPI number?

The NPI number for Elise Distefano is 1104659713. It was assigned to this individual provider in the NPPES registry on August 21, 2024. The provider is also known as Elise Dewey PA.

Q: What is Elise Distefano's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Elise Distefano was last updated on October 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 days 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 August 21, 2024PECOS EnrolledAccepts Medicare Assignment

1103 W LIBERTY ST, FARMINGTON, MO 63640(573) 760-8090(573) 760-8260 Get Directions Write a Review

NPPES record last updated: October 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Oct 6, 2026, Aug 21, 2024 (2 updates tracked since 2024).

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About Elise K Distefano Pa-c NPPES

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

ELISE K DISTEFANO PA-C (NPI 1104659713) is an individual physician assistant in Farmington, Missouri, licensed in Missouri (2024039608) and active in the NPI registry since August 2024. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and maintains a secondary practice location in Cape Girardeau.

NPPES Registry Identity

NPI1104659713

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameELISE K DISTEFANOCredential: PA-C

Location Address1103 W LIBERTY STFarmington, MO 63640-1921

Mailing AddressPo Box 959354Saint Louis, MO 63195-9354 · (573) 760-8090 · Fax (573) 760-8260

Phone(573) 760-8090

Fax(573) 760-8260

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateAugust 21, 2024

Last NPPES UpdateOctober 6, 20262 updates tracked since enumeration

NPPES CertifiedOctober 6, 2026

✔ NPI 1104659713 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MO · 2024039608

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1103 W LIBERTY ST, Farmington, MO 63640

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Other Names 1

Former Name (1)Elise Dewey Pa

Secondary Practice Location 1

Location 1211 Saint Francis DrCape Girardeau, MO 63703-5049 · Phone (573) 331-5110 · Fax (573) 335-4689

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Elise K Distefano Pa-c 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 ID2769914183

PECOS Enrollment IDI20241010000824

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.

Saint Francis Medical Center

Acute Care Hospitals · Cape Girardeau, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260183

Location211 St Francis DrCape Girardeau, MO 63703 · Cape Girardeau County

Emergency services Birthing friendly

Iron County Medical Center

Critical Access Hospitals · Pilot Knob, MO

OwnershipGovernment - Hospital District or Authority

CMS Certification Number261336

Location301 North Highway 21Pilot Knob, MO 63663 · Iron County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63640 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. THOMAS J KIRISITS DPM

Podiatrist