Anthony Distefano, Jr MD
Anthony Distefano, Jr MD is a healthcare organization registered as Adult Medicine Physician in Worcester, MA, holding Type 2 (organization) NPI 1063646552 since 2009. The authorized official on file is Anthony Distefano, Owner.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1063646552 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Anthony Distefano, Jr MD |
| Practice address | 562 LINCOLN ST, Worcester, MA, 01605 |
| Phone | 5088526028 |
| Fax | 5087217821 |
| Enumeration date | 2009-05-12 |
| Last updated in NPPES | 2009-05-12 |
Authorized official
| Name | Anthony Distefano |
|---|---|
| Title | Owner |
| Phone | 5088526028 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 207QA0505X | Adult Medicine Physician | Primary | 21567 | MA |
Copy-ready billing details
Provider: Anthony Distefano, Jr MD NPI: 1063646552 Taxonomy: 207QA0505X (Adult Medicine Physician) Address: 562 LINCOLN ST, Worcester, MA, 01605
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1780995894 | Anthony J Distefano III DDS PC | Organization | Dentist | Worcester, MA |
| 1750009429 | Hum Tum Care | Organization | Foster Care Agency | Worcester, MA |
Verify this record
Cross-check NPI 1063646552 against the authoritative CMS record: view Anthony Distefano, Jr MD on the official NPPES registry .
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 or validate an NPI number.
Frequently asked questions
What is the NPI number for Anthony Distefano, Jr MD?
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2009-05-12.