Nicholas Carroll Destefano, MD
General Practice Physician · Fort Gordon, GA
Nicholas Carroll Destefano, MD is a general practice physician with a practice address in Fort Gordon, Georgia, and NPI 1154776755, issued on May 2, 2016. Check the license on the Georgia Composite Medical Board; the Medicare figures below come from public CMS files.
- Name
- Nicholas Carroll Destefano
- Credential
- MD
- Primary taxonomy
- General Practice Physician 208D00000X
- License numbers
- 30177 NE
C1-0028577 DE
Self-reported in NPPES; status is on the state search - Practice location
- 300 E Hospital RD, Fort Gordon, GA 30905
- Phone
- (706) 383-5299
- Enumerated
- May 2, 2016
- Record last updated
- Dec 10, 2025
- Medicare enrollment
- Enrolled (PECOS I20251219002133); accepts Medicare assignment
- Medical or professional school
- Wayne State University School Of Medicine, 2016
- Telehealth
- Offers telehealth (CMS)
- Entity
- Type 1 · individual
8 nearest general practice physician records → All 316 in Georgia → Look up another NPI →
Also registered at 300 E Hospital RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Dariam Acevedo SantiagoPhysical Therapist1225764830
- Benjamin AdkinsFamily Nurse Practitioner1366375172
- Lauren Bettencourt, DOFamily Medicine Physician1205687373
- Aaron Brothers, M.D.Urology Physician1477874568
- Timothy Burch, PSY.D.Clinical Psychologist1649415191
- Christian Mark CarlosStudent in an Organized Health Care Education/Training Program1578416764
Verify Nicholas Carroll Destefano in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersGeorgia Composite Medical BoardCheck the board
- 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Beebe Physician Network Inc.Lewes, DE
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Nicholas Carroll Destefano among 316 general practice physician records in Georgia
Nicholas Carroll Destefano, MD is one of 316 general practice physician records with a practice address in Georgia. 49% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2016, is newer than 77% of them.
- NPI issued2016 · 77% of these records are older, 21% newer
- In a Medicare fileYes · 49% of these records are
- In the CMS Doctors and Clinicians fileYes · 26% of these records are
- Graduated2016 · median 2000 among the 83 with a school on file
- Record last updated2025 · 59% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 208D00000X and a Georgia practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
General Practice Physician providers in Georgia
There are 316 general practice physician records in Georgia.
All 316 in Georgia → Every provider in Fort Gordon → General Practice Physician nationwide →
The 8 general practice physician records with the nearest ZIP codes
- Philip Aubrey, MDFort Eisenhower, GA 309051710727151
- Gregory Hill, MDFort Gordon, GA 309051689209611
- Constance Larson, MDFort Gordon, GA 309051568951622
- Joseph Mansfield, M.D.Ft Gordon, GA 309051932562816
- Rebecca Philpott, MDFort Gordon, GA 309051689312886
- Rachelle Scuderi, DOFort Eisenhower, GA 309051649034265
- Andrew Sprader, DOFort Gordon, GA 309051124767736
- Linda Faulk, M.D.Augusta, GA 309041376704635
Common questions
What is Nicholas Carroll Destefano, MD's NPI number?
Nicholas Carroll Destefano, MD's National Provider Identifier (NPI) is 1154776755, issued on May 2, 2016. An NPI identifies a provider in billing; it is not a license.
Where is Nicholas Carroll Destefano, MD located?
The NPPES record lists a practice address at 300 E Hospital RD, Fort Gordon, GA, 30905. Phone: (706) 383-5299. Providers update this record themselves, so call before visiting.
How can I verify Nicholas Carroll Destefano, MD's license?
Search the Georgia Composite Medical Board at https://medicalboard.georgia.gov/. The NPPES record confirms identity only; the state search shows license status, expiration and public orders.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.