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DOUGLAS P DISTEFANO LPC
NPI 1558072454
Counselor - Mental Health in Phoenix, AZ

Active since December 12, 2022PECOS Enrolled
1919 E THOMAS RD, PHOENIX, AZ 85016(602) 933-0414 Get Directions Write a Review

NPPES record last updated: August 28, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 28, 2023, Dec 12, 2022 (2 updates tracked since 2022).

About Douglas P Distefano Lpc NPPES

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

DOUGLAS P DISTEFANO LPC (NPI 1558072454) is an individual mental health provider in Phoenix, Arizona, licensed in Arizona (LPC-21266) and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1558072454
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameDOUGLAS P DISTEFANOCredential: LPC
Location Address1919 E THOMAS RDPhoenix, AZ 85016-7710
Mailing Address2108 E Thomas Rd Ste 130Phoenix, AZ 85016-7761 · (602) 933-1813
Phone(602) 933-0414
Sole ProprietorNo
Enumeration DateDecember 12, 2022
Last NPPES UpdateAugust 28, 20232 updates tracked since enumeration
NPPES CertifiedAugust 28, 2023
✔ NPI 1558072454 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in AZ · LPC-21266
1919 E THOMAS RD, Phoenix, AZ 85016
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna HealthCare of Arizona, Inc, Oscar Health Plan, Inc..Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Douglas P Distefano Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

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

Phoenix Children's Hospital
Same address
Pediatrics
1919 E THOMAS RD
Phoenix, AZ 85016
  • Reassigned Medicare billing, Arizona enrollment
  • 1,416 clinicians in this Medicare group
NPI 1922112044 (602) 933-1000

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

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. TIMUR RAGHIB M.D.
Hospitalist
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0777
MRS. MARIA T ESCOBAR CSP, RD
Dietitian, Registered
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (480) 440-2787
DR. AHMAR HUSAIN MD
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
MRS. SOLEE R COWLEY LCSW
Social Worker (Clinical)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0414
MR. SEAN PATRICK BRADY DO
Anesthesiology (Pediatric Anesthesiology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-4660
PRIYA PRASHER M.D.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1900
DR. AMIT RAJARAM D.O.
Pediatrics
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-0198
LAURA GARDNER HAMANT
Pediatrics (Pediatric Gastroenterology)
1919 E THOMAS RD
PHOENIX, AZ 85016
Maricopa County (602) 933-1000

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 Douglas Distefano's NPI number?

The NPI number for Douglas Distefano is 1558072454. It was assigned to this individual provider in the NPPES registry on December 12, 2022.

Where is Douglas Distefano located?

Douglas Distefano practices at 1919 E Thomas Rd, Phoenix, AZ 85016. The listed phone number is (602) 933-0414.

What is Douglas Distefano's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Douglas Distefano enrolled in Medicare?

Yes. Douglas Distefano is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Douglas Distefano's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Douglas Distefano reassigns Medicare benefits to Phoenix Children's Hospital (Phoenix, AZ). 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 Douglas Distefano's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Douglas Distefano accept?

Health plans from Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. list Douglas 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.

When was this NPI record last updated?

The NPPES record for Douglas Distefano was last updated on August 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.