Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Michael Destefano, MD

Individual provider Psychiatry Physician · NPI 1407200116

Dr. Michael Destefano, MD is a Psychiatry in Port Jefferson, New York. Qualified in 2016, 10 years ago. Practices with Aldad Medical PC, a 80-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
10
Licensed in
NY
In the registry since
2016
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

75 N Country Rd
Port Jefferson, NY 11777-2119
Phone: (631) 473-1320
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 301867 (NY)

Record details

NPI number1407200116
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 19, 2016
Last updated in NPPESFebruary 3, 2021
Certification dateFebruary 3, 2021
Mailing address75 N Country Rd, Port Jefferson, NY 11777-2119

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Aldad Medical Pc — 80 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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