MARY GRACE DISTEFANO RN ANP
NPI 1710328968
Nurse Practitioner - Adult Health in Depew, NY
About Mary Grace Distefano Rn Anp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY GRACE DISTEFANO RN ANP (NPI 1710328968) is an individual adult health provider in Depew, New York, licensed in New York (306403) and active in the NPI registry since July 2013. She 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)
Mary Grace Distefano Rn Anp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
5Medicare enrollment records show Mary Distefano reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Depew, NY 14043
- Reassigned Medicare billing, New York enrollment
- 18 clinicians in this Medicare group
Williamsville, NY 14221
- Reassigned Medicare billing, New York enrollment
- 332 clinicians in this Medicare group
Buffalo, NY 14202
- Reassigned Medicare billing, New York enrollment
- 129 clinicians in this Medicare group
Buffalo, NY 14202
- Reassigned Medicare billing, New York enrollment
- 127 clinicians in this Medicare group
Tarrytown, NY 10591
- Reassigned Medicare billing, New York enrollment
- 76 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 14043 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 8
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
DEPEW, NY 14043
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 Mary Distefano's NPI number?
The NPI number for Mary Distefano is 1710328968. It was assigned to this individual provider in the NPPES registry on July 16, 2013.
Where is Mary Distefano located?
Mary Distefano practices at 3332 Walden Ave Ste 110, Depew, NY 14043. The listed phone number is (716) 668-7051.
What is Mary Distefano's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.
Is Mary Distefano enrolled in Medicare?
Yes. Mary Distefano is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mary Distefano's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Distefano reassigns Medicare benefits to 5 organizations: Family Choice Of New York Medical PC (Depew, NY), Trinity Medical Wny PC (Williamsville, NY), Mobile Physician Services PLLC (Buffalo, NY), Physician Mobile Medical Care PC (Buffalo, NY) and Care Connect Medical P.C. (Tarrytown, NY). Each 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 Mary Distefano'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 Mary Distefano was last updated on July 16, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Mary Grace Distefano, RN ANP · NPI 1710328968
Adult Health physician in Depew, New York. Individual provider, active in the CMS NPPES registry since July 16, 2013.
## Identity
- **NPI:** 1710328968 (Entity type: Individual)
- **Enumerated:** July 16, 2013
- **Primary specialty:** Nurse Practitioner - Adult Health · taxonomy 363LA2200X
- **State license:** 306403 (New York)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3332 WALDEN AVE STE 110, Depew, NY 14043-2400
- **Phone:** (716) 668-7051
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 5 organizations under Medicare reassignment (form CMS-855R): Family Choice Of New York Medical PC (NPI 1720312754, Depew, NY); Trinity Medical Wny PC (NPI 1144878893, Williamsville, NY); Mobile Physician Services PLLC (NPI 1194132415, Buffalo, NY); Physician Mobile Medical Care PC (NPI 1518765502, Buffalo, NY); Care Connect Medical P.C. (NPI 1457032328, Tarrytown, NY) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 16, 2013
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Source: [NPI Profile](https://npiprofile.com/npi/1710328968) · Data from the CMS NPPES public registry.