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

Individual provider Physical Therapist · NPI 1609583145

Jason Distefano, DPT is a Physical Therapist in Private Practice in Northport, New York. Qualified in 2022, 4 years ago. Practices with Ivyrehab Physical Therapy, Occupational Therapy and Speech Language PA, a 385-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
4
Licensed in
NY
In the registry since
2022
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

389 Fort Salonga Rd
Northport, NY 11768-3089
Phone: (631) 261-0444
Fax: (631) 261-3112
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 050122 (NY)

Record details

NPI number1609583145
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedNovember 3, 2022
Last updated in NPPESFebruary 14, 2023
Certification dateFebruary 14, 2023
Mailing address1311 Mamaroneck Ave Ste 140, White Plains, NY 10605-5224

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ivyrehab Physical Therapy, Occupational Therapy And Speech Language Pa — 385 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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