John Distasio
M.D. | Pediatrics | Male
John Distasio, M.D. is a Fort Myers, Florida based Pediatric doctor with medical specialization in
General Pediatrics.
Current practice location of John Distasio is
4751 S Cleveland Ave, Fort Myers, Florida - 33907. He can be contacted on phone at
239-343-9888 and fax number 239-343-9868.
John Distasio is a sole proprietor of his business.
NPI number (Unique professional ID) for John Distasio is
1457351611 which was assigned by NPPES on 28 Jul, 2005 and it was last updated on 25 Mar, 2021.
John Distasio license number is
ME57595 for Pediatrics (208000000X) in Florida.
John Distasio is a pediatrician who is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Complete Profile:
John Distasio basic information including his official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics |
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| Provider Name : | John Distasio |
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| Credential : | M.D. |
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| Gender : | Male |
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Business Address:
John Distasio address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 4751 S Cleveland Ave
Fort Myers, FL, 33907
United States |
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| Phone Number : | 239-343-9888 |
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| Fax Number : | 239-343-9868 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1457351611 |
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| NPI Entity Type : | Individual |
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| First Enrolment Date : | 28 Jul, 2005 |
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| Last Updated On : | 25 Mar, 2021 |
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Medicare Participation:
John Distasio participates in medicare and accepts medicare insurance either directly or through association with group practice or medical facility.
| Medicare PECOS ID : | 9638352107 |
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| Medicare Enrollment ID : | I20110321000671 |
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| Primary Specialty : | Pediatric Medicine |
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| Medical School : | University Of Miami, Lm Miller School Of Medicine |
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| Graduation Year : | 1985 |
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| Accepts Medicare? | Yes. John Distasio accepts medicare insurance. |
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Group Practice Association:
John Distasio is associated with following Group Practice Organizations. Group practices are practice of medicine by a group of physicians who share their premises and other resources. Following list states all the group name with which John Distasio is associated with along with the number of members in that group. He may also accept medicare indirectly via these group practices.
| Organisation Name : | Group Practice ID | No. of Members | Practice Address | Group Accepts Medicare |
|---|
| Lee Memorial Health System | 8729996608 | 925 | 4751 S Cleveland Ave
Fort Myers, FL - 339071317
Ph: 2393439888 | Yes |
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for John Distasio are as mentioned. Primary taxonomy code for John Distasio, M.D. is
208000000X (Pediatrics).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 208000000X | Pediatrics | Yes | ME57595 | FL |
Legacy Identifiers:
Other legacy medical identifiers of John Distasio such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 063826900 | MEDICAID | FL | |
Other Practice Locations:
| Practice Address | City, State | Phone Number |
|---|
4771 S CLEVELAND AVE,
FORT MYERS, FL, 33907-1317
United States | FORT MYERS, FL | 239-343-9800 |
Endpoints:
Endpoints provide a simple, secure, scalable, and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet. It is used by EHR systems (Electronic Health Records).
| Endpoint Type | Endpoint | Affiliation | Use | Content | Address |
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DIRECT
(Direct Messaging Address) | jdistasio378@Direct.leememorial.org
| |
|
| 2776 CLEVELAND AVE,
FORT MYERS, FL, 33901-5864
United States |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | Po Box 2147
Ft Myers, FL, 33902-2147
United States |
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| Phone Number : | 239-343-9888 |
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| Fax Number : | 239-343-9868 |
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Business Location:
Patients can refer following map for directions to
John Distasio practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 January, 2024.