ARCANGELO DISTEFANO MD
NPI 1902869415
Internal Medicine - Geriatric Medicine in Bridgeport, CT
About Arcangelo Distefano Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ARCANGELO DISTEFANO MD (NPI 1902869415) is an individual geriatric medicine provider in Bridgeport, Connecticut, licensed in Connecticut (028828) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Other Identifiers 3
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Arcangelo Distefano Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Arcangelo Distefano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Bridgeport, CT 06610
- Reassigned Medicare billing, Connecticut enrollment
- 1,824 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.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 06606 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Referred Medical Equipment & Supplies CMS DME claims 2
Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.
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.
BRIDGEPORT, CT 06606
BRIDGEPORT, CT 06606
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 Arcangelo Distefano's NPI number?
The NPI number for Arcangelo Distefano is 1902869415. It was assigned to this individual provider in the NPPES registry on April 7, 2006.
Where is Arcangelo Distefano located?
Arcangelo Distefano practices at 3180 Main St Suite 301, Bridgeport, CT 06606. The listed phone number is (203) 373-9100.
What is Arcangelo Distefano's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Geriatric Medicine, with taxonomy code 207RG0300X.
Is Arcangelo Distefano enrolled in Medicare?
Yes. Arcangelo Distefano is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Arcangelo Distefano's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Arcangelo Distefano reassigns Medicare benefits to Northeast Medical Group, Inc. (Bridgeport, CT). 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 Arcangelo 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 Arcangelo Distefano was last updated on May 31, 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.
# Arcangelo Distefano, MD · NPI 1902869415
Geriatric Medicine physician in Bridgeport, Connecticut. Individual provider, active in the CMS NPPES registry since April 7, 2006.
## Identity
- **NPI:** 1902869415 (Entity type: Individual)
- **Enumerated:** April 7, 2006
- **Primary specialty:** Internal Medicine - Geriatric Medicine · taxonomy 207RG0300X
- **State license:** 028828 (Connecticut)
- **Sole proprietor:** No
## Practice location
- **Address:** 3180 MAIN ST, SUITE 301, Bridgeport, CT 06606-4237
- **Phone:** (203) 373-9100 · **Fax:** (203) 365-8492
## 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:** Northeast Medical Group, Inc. (NPI 1043278351, Bridgeport, CT), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 31, 2013
- **Other identifiers:** Medicare UPIN D02513; Medicare ID-Type Unspecified 110006317 (CT); Medicaid 001288283 (CT)
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Source: [NPI Profile](https://npiprofile.com/npi/1902869415) · Data from the CMS NPPES public registry.