Type 1 · Individual ✓ Active NPI ✓ Valid NPI checksum

Kellie Distefano, PA-C

Family Medicine Physician in Hartford, MI · enumerated 2006 · practices at Lakeland Community Hospital Watervliet.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1386609543

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Registry record

Entity type Individual (Type 1)

Name Kellie Distefano

Credential PA-C

Sex Female

Practice address 525 S Center St, Hartford, MI, 49057

Phone (269) 621-4063

Fax (269) 621-9972

Enumeration date Apr 19, 2006

Last updated in NPPES Dec 18, 2007

Taxonomy & licenses

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 5601002464 (MI) Primary

363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers · License 5601002464 (MI) Secondary

Other identifiers

Identifier	Type	State	Issuer
06116A	Other	MI	BHP PROVIDER ID #
381368745126	Other	MI	CCM BILLING # FOR PA-C
101465	Other	MI	GLHP PIN #
KD002464	Other	MI	BCBS PROVIDER ID #
KD09184	Other	MI	HPM PROVIDER ID #

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

Where does Kellie Distefano practice?

The practice location on file with NPPES is in Hartford, MI. Providers can have multiple locations; NPPES lists the primary practice address.

What is the NPI number for Kellie Distefano?

The National Provider Identifier (NPI) for Kellie Distefano is 1386609543, a Type 1 (individual) record in the CMS NPPES registry.

Other providers at this practice address

Browse all →

Lakeland Community Hospital Watervliet Rural Health Clinic/Center · Hartford, MI NPI 1023114741 Jay Shah Family Medicine Physician · Hartford, MI NPI 1487974663 Tamara Gaishin Physician Assistant · Hartford, MI NPI 1508115965 Laura Gonzalez Family Nurse Practitioner · Hartford, MI NPI 1306438288 Ann Tapper Nurse Practitioner · Hartford, MI NPI 1144992983

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2007-12-18.