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NPI · 1104251685 · NPPES-sourced

Miss Marielle Destefano PA-C

ActivePhysician Assistant
NPI Number
1104251685
Type 1 · Individual
Taxonomy Code
363A00000X
Contact
(410) 550-0100
Primary practice line
Last Updated
About 7 years ago (May 2019)
Enumerated 2013-09-04
Primary practice addressMD · 21224-2735
4940 Eastern AveBaltimore, MD 21224-2735
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Also known as

  • Formerly known asGibbons, Marielle

Source: NPPES public registry.

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About this NPIWhat this record shows.

NPI 1104251685 is registered to Miss Marielle Destefano PA-C, a Physician Assistant practising at 4940 Eastern Ave in Baltimore, Maryland. Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy. Miss Marielle Destefano PA-C has been enumerated in the National Provider Identifier (NPI) registry since 2013.

Provider type
Individual (Type 1)
Status
Active
Enumerated
2013-09-04
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Medicare enrollment

This provider holds a Medicare enrollment on file with the Provider Enrollment, Chain and Ownership System (PECOS). Each enrollment carries a public Medicare Enrollment ID (ENRLMT_ID) used by billers and intermediaries.

Practitioner

Source: CMS PECOS public enrollment file.

Insurance & acceptsHow to confirm coverage.

The National Plan and Provider Enumeration System (NPPES) registry does not include commercial insurance network data, so we cannot show which plans Miss Marielle Destefano PA-C accepts. To confirm in-network status with your specific health plan, contact Miss Marielle Destefano PA-C directly at (410) 550-0100.

Frequently asked

Yes. NPI 1104251685 is registered as Active in the CMS NPPES public registry and passes the Luhn check-digit validation that all 10-digit NPIs use.

Physician Assistant is a recognised medical specialty under the National Uniform Claim Committee (NUCC) taxonomy.

The CMS NPPES Public Registry at npiregistry.cms.hhs.gov is the authoritative source. FindMyNPI mirrors this dataset and refreshes monthly. For real-time verification, you can also call the provider's office at (410) 550-0100.

An individual healthcare provider has a single Type-1 NPI for life. Organisations can hold separate Type-2 NPIs per location, specialty, or sub-entity. Miss Marielle Destefano PA-C is a Type-1 individual NPI.

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Quick facts

Provider typeIndividual
Taxonomy363A00000X
Last updated2019-05
Enumerated2013-09-04
StatusActive
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2 records · same addressOther providers at this location.

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Same specialtyOther Physician Assistant providers in Maryland.

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Adjacent in the NPPES enumeration sequenceNPIs enumerated around this one.

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