MARY GRACE DISTEFANO RN ANP
NPI 1710328968
Nurse Practitioner - Adult Health in Depew, NY

Q: 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.

Q: What is Mary Distefano's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: 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.

Active since July 16, 2013PECOS Enrolled

3332 WALDEN AVE STE 110, DEPEW, NY 14043(716) 668-7051 Get Directions Write a Review

NPPES record last updated: July 16, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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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

NPI1710328968

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMARY GRACE DISTEFANOCredential: RN ANP

Location Address3332 WALDEN AVE STE 110Depew, NY 14043-2400

Mailing Address28 Park DrWilliamsville, NY 14221-6935 · (716) 949-1086

Phone(716) 668-7051

Sole ProprietorYes

Enumeration DateJuly 16, 2013

✔ NPI 1710328968 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · 306403

3332 WALDEN AVE STE 110, Depew, NY 14043

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Grace Distefano Rn Anp 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.

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.

New Patient

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

Most-billed visit code 99214

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 9

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

MELANIE ANNE CARTER NP

Nurse Practitioner (Adult Health)