DR. JOHN DESTEFANO DPM
NPI 1124289111
Podiatrist in Fort Polk, LA
About Dr. John Destefano Dpm NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JOHN DESTEFANO DPM (NPI 1124289111) is an individual podiatrist in Fort Polk, Louisiana, licensed in Florida (PO 3715) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. John Destefano Dpm is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show John Destefano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Fort Myers, FL 33919
- Reassigned Medicare billing, Florida enrollment
- 2 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 71459 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 John Destefano's NPI number?
The NPI number for John Destefano is 1124289111. It was assigned to this individual provider in the NPPES registry on June 23, 2008.
Where is John Destefano located?
John Destefano practices at 1585 3rd St, Fort Polk, LA 71459. The listed phone number is (337) 531-3427.
What is John Destefano's specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
Is John Destefano enrolled in Medicare?
Yes. John Destefano is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for John Destefano's services?
According to the CMS Revalidation Reassignment List (October 2026 release), John Destefano reassigns Medicare benefits to Foot And Ankle Care Of The Island Coast PA (Fort Myers, FL). 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 John 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 John Destefano was last updated on November 14, 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.
# Dr. John Destefano, DPM · NPI 1124289111
Podiatrist provider in Fort Polk, Louisiana. Individual provider, active in the CMS NPPES registry since June 23, 2008.
## Identity
- **NPI:** 1124289111 (Entity type: Individual)
- **Enumerated:** June 23, 2008
- **Primary specialty:** Podiatrist · taxonomy 213E00000X
- **State license:** PO 3715 (Florida)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1585 3RD ST, Fort Polk, LA 71459-5102
- **Phone:** (337) 531-3427
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health
- **Bills Medicare through:** Foot And Ankle Care Of The Island Coast PA (NPI 1750437166, Fort Myers, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 14, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1124289111) · Data from the CMS NPPES public registry.