Michael Distefano
NPI 1124647631 · Physical Therapist · Staten Island, NY
Enrolled with Medicare as Practitioner - Physical Therapist in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Michael Distefano is a Physical Therapist provider in Staten Island, NY (NPI 1124647631).
Provider details
- NPI number
- 1124647631
- Entity type
- Individual
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 012677 (NY)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4870 Hylan BlvdStaten Island, NY 10312-6322Phone: (718) 200-4122
Registry dates
- Enumerated
- 2020-04-14
- Last updated
- 2020-04-14
- Certified
- 2020-04-14
Frequently asked questions
- What is Michael Distefano's NPI number?
- Michael Distefano's National Provider Identifier (NPI) is 1124647631, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Michael Distefano's specialty?
- Michael Distefano is listed in the NPPES registry with a primary specialty of Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Michael Distefano located?
- Michael Distefano's practice location on file with NPPES is 4711 Hylan Blvd, Staten Island, NY 10312-6311.
- What is Michael Distefano's phone number?
- The practice phone number listed in the NPPES registry for Michael Distefano is (347) 739-3778.
- Does Michael Distefano accept Medicare?
- Michael Distefano is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Michael Distefano's NPI active?
- Yes — Michael Distefano's NPI (1124647631) is active in the NPPES registry as of the last update on 2020-04-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.