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

Mike Destine

Individual provider Medical Physician Assistant · NPI 1679995674

Mike Destine is a Physician Assistant in Randallstown, Maryland. Qualified in 2013, 13 years ago. Practices with Emergency Medicine Associates PA, PC, a 704-clinician group and accepts Medicare assignment.

Years since qualifying
13
In the registry since
2014

Practice location Address checks out

5401 Old Court Rd
Randallstown, MD 21133-5103
Phone: (914) 618-2312
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X

Record details

NPI number1679995674
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 9, 2014
Last updated in NPPESJanuary 9, 2014
Mailing address1765 Countrywood Ct, Hyattsville, MD 20785-4012

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Emergency Medicine Associates P.A., P.C. — 704 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Randallstown