ELIZABETH NOEL DISTEFANO OD
NPI 1639458276
Optometrist in Wayne, WV

Q: What is Elizabeth Distefano's NPI number?

The NPI number for Elizabeth Distefano is 1639458276. It was assigned to this individual provider in the NPPES registry on August 14, 2011. The provider is also known as Elizabeth Noel Randolph Od.

Q: What is Elizabeth Distefano's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Active since August 14, 2011PECOS EnrolledAccepts Medicare Assignment

42 MCGINNIS DR, WAYNE, WV 25570(304) 272-5136(304) 272-6261 Get Directions Write a Review

NPPES record last updated: May 28, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Elizabeth Noel Distefano Od NPPES

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

ELIZABETH NOEL DISTEFANO OD (NPI 1639458276) is an individual optometrist in Wayne, West Virginia, licensed in West Virginia (2045-IOD) and active in the NPI registry since August 2011. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Indiana University - School Of Optometry (2011).

NPPES Registry Identity

NPI1639458276

Entity TypeIndividualFemale

Primary Taxonomy152W00000X

Provider Legal NameELIZABETH NOEL DISTEFANOCredential: OD

Location Address42 MCGINNIS DRWayne, WV 25570-9553

Mailing Address2585 3rd AveHuntington, WV 25703-1642 · (304) 697-1396 · Fax (304) 697-2086

Phone(304) 272-5136

Fax(304) 272-6261

Sole ProprietorNo

Medical School CMSIndiana University - School Of OptometryGraduated 2011

Enumeration DateAugust 14, 2011

Last NPPES UpdateMay 28, 2024

NPPES CertifiedMay 28, 2024

✔ NPI 1639458276 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

Licenses✔ Licensed in WV · 2045-IOD✔ Licensed in VA · 0618002273

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

42 MCGINNIS DR, Wayne, WV 25570

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Other Names 1

Former Name (1)Elizabeth Noel Randolph Od

Secondary Practice Locations 2

Location 1145 Holt Garrison PkwyDanville, VA 24540-5958 · Phone (434) 483-2199 · Fax (434) 710-4910

Location 285 Donohoe DrHuntington, WV 25705-8887 · Phone (304) 399-3310 · Fax (304) 523-5416

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter from Meridian 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

Elizabeth Noel Distefano Od 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 ID3072860261

PECOS Enrollment IDI20180718004096

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25570 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

$124.46 typical visit price

range $53.20 – $164.59

Typical copayment $31.11 (range $13.30 – $41.14)

Most-billed visit code 99204

Established Patient

$66.84 typical visit price

range $16.47 – $133.29

Typical copayment $16.71 (range $4.11 – $33.32)

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 10

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

MRS. KALA ELAINE MICHELS MSW, LCSW

Social Worker (Clinical)