Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154776755 Individual Practitioner Male Practitioner

Dr. Nicholas Carroll Destefano , MD

General Practice • Fort Gordon, GA

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Nicholas Destefano, MD is a certified General Practice practicing in Fort Gordon, GA. With approximately 10 years of clinical experience since graduating from Wayne State University School Of Medicine in 2016, Dr. Destefano delivers high-quality medical care to the local community at 300 E HOSPITAL RD.

Dr. Destefano is affiliated with Beebe Physician Network Inc. and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Practice Location & Contact Primary Location

Practice Address

300 E Hospital Rd

Fort Gordon, GA 30905

Telephone 7063835299
Associated Practice Facility / Clinic

Medicare Profile & Education

Medical School

Wayne State University School Of Medicine

Graduation Year

2016

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Fort Gordon, GA

Established Specialist (10-20 Yrs)
Practitioner Clinical Experience
10 Yrs +1.0 yrs vs City Avg
City Avg: 9.0 Yrs
State Avg: 28.9 Yrs
Regional Practice Density
5 Specialists

Practicing in Fort Gordon, GA (369 Statewide)

Telehealth Adoption Rate
20.0% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Destefano (10 Years) 10 Yrs
Fort Gordon Specialty Average (9.0 Years) 9.0 Yrs

Medical Specialties & State Licenses

CMS Verified: 2025-12-10
General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License NE 30177

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Family Medicine

NUCC Taxonomy Code: 207Q00000X

State License DE C1-0028577

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Hospital & Practice Group Affiliations

Beebe Physician Network Inc.

424 Savannah Rd, Lewes, DE 199581462

Phone: 3026453525

Secondary Practice Locations

32050 Long Neck Rd

Millsboro, DE 199666228

Phone: 3026453150

424 Savannah Rd

Lewes, DE 199581462

Phone: 3026453150

12100 Black Swan Dr Ste 104

Lewes, DE 199584991

Phone: 3026451315

17388 N Village Main Blvd Unit 21

Lewes, DE 199587240

Phone: 3022916050

21635 Biden Ave Unit 101

Georgetown, DE 199474575

Phone: 3028569596

100 Silicato Pkwy Ste 201

Milford, DE 199631273

Phone: 3023932056

28538 Dupont Blvd Unit 1

Millsboro, DE 199664791

Phone: 3028293294

232 Mitchell St Unit 301

Millsboro, DE 199669412

Phone: 3023164190

32550 Docs Pl Unit 2

Millville, DE 199676975

Phone: 3025394302

23900 Milton Ellendale Hwy Ste 101

Milton, DE 199682714

Phone: 3026842033

18947 John J Williams Hwy Unit 303

Rehoboth Beach, DE 199714477

Phone: 3026440690

36450 Tidal Rd Unit 2

Selbyville, DE 199754596

Phone: 3022916045

1008 Kings Hwy

Lewes, DE 199581932

Phone: 3022916031

36223 Farm Ln Ste 140

Rehoboth Beach, DE 199711329

Phone: 3022271268

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

30 Associated Practitioners
Dr. Matthew Dellen , MD

Student in an Organized Health Care Education/Training Program

NPI 1013641406

Doctor of Medicine (M.D.)

Dr. Waqas Haq , MD

Internal Medicine

NPI 1063152148

Doctor of Medicine (M.D.)

Paul Moore , PTA

Physical Therapy Assistant

NPI 1194065854

Physical Therapist Assistant

NPI 1205687373

Doctor of Osteopathic Medicine (D.O.)

Dr. Randy Georgemiller , PhD

Clinical Neuropsychologist

NPI 1205904950

Doctor of Philosophy (Ph.D.)

Dariam Acevedo Santiago

Physical Therapist

NPI 1225764830

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
📍
Updated Practice Location September 20, 2023

Registered at 300 E HOSPITAL RD, FORT GORDON, GA 30905 (Tel: 7063835299)

📍
Updated Business Mailing Address September 20, 2023

Registered at 300 E HOSPITAL RD, FORT GORDON, GA 30905 (Tel: 7063835299)

📍
Updated Practice Location July 15, 2021

Registered at 390 N LOOP RD, FORT IRWIN, CA 92310 (Tel: 7603835284)

📍
Updated Business Mailing Address July 15, 2021

Registered at 390 N LOOP RD, FORT IRWIN, CA 92310 (Tel: 7603835200)

📍
Updated Business Mailing Address February 11, 2019

Registered at 9040 FITZSIMMONS DR, TACOMA, WA 984311000 (Tel: 2539681340)

NPI Profile Active September 25, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location September 25, 2017

Registered at 9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 984311000 (Tel: 2539681340)

📍
Updated Business Mailing Address September 25, 2017

Registered at 9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 984311000 (Tel: 2539681340)

👤
Provider Name / Credentials Updated September 25, 2017

Recorded as NICHOLAS DESTEFANO, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 25, 2017

General Practice (License #30177 in NE)

NPI Profile Active May 02, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location May 02, 2016

Registered at 9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 984311000 (Tel: 2539681340)

📍
Updated Business Mailing Address May 02, 2016

Registered at 9040 FITZSIMMONS DR, JOINT BASE LEWIS MCCHORD, WA 984311000 (Tel: 2539681340)

👤
Provider Name / Credentials Updated May 02, 2016

Recorded as NICHOLAS DESTEFANO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 02, 2016

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration May 02, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154776755
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 02, 2016
Last Update: December 10, 2025
Sole Proprietor: No

Mailing Address

300 E Hospital Rd

Fort Gordon, GA 30905

Phone: 7063835299

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.