JOHN R. DESTITO (DO) – Emergency Medicine Physician, NPI 1770540841

JOHN R. DESTITO (DO) is a healthcare provider. based in Atlanta, Georgia. specializing in Emergency Medicine Physician. They hold the professional credentials DO. They hold a License No. 052346 (GA). The NPI Number for JOHN R. DESTITO (DO) is 1770540841

Main info

Male
38 Years Of Experience
Accepts Medicare Assignment
Name
JOHN R. DESTITO (DO)
NPI
1770540841
Phone
(404) 355-8775
Address
1800 HOWELL MILL RD NW
Enumeration Date
1 May 2006
Last Update Date
16 April 2010

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6782058155
Graduation Year
1988 (38 years ago)
PAC ID
3476455312
Group Practice PAC ID
0345493375
Professional Enrollment ID
I20160523000917
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JOHN R. DESTITO (DO)

  • 1800, Howell Mill Road Northwest, Atlantic Station, Atlanta, Georgia, 30318, United States

    SUITE 130

    ATLANTA, GA 303182538

    Phone: (404) 355-8775

    Fax: (404) 355-8772

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-05-23

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160523000917IGeneral PracticeGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30318)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0345493375View full group profile
NameSpecialtyState
Family PracticeGA
Nurse PractitionerGA
Family PracticeGA
Nurse PractitionerGA
-GA
Nurse PractitionerGA
Internal Medicine, Emergency MedicineMI
Nurse PractitionerAL
Nurse PractitionerGA
Nurse PractitionerAL

Reviews

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Frequently asked questions

Does JOHN R. DESTITO (DO) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — JOHN R. DESTITO (DO) uses 1770540841.
Is JOHN R. DESTITO (DO) still practicing?
JOHN R. DESTITO (DO) is currently listed as active in the public NPI registry.
What taxonomy line describes JOHN R. DESTITO (DO)?
For research purposes, treat JOHN R. DESTITO (DO) as Emergency Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
Where is JOHN R. DESTITO (DO) based?
JOHN R. DESTITO (DO) is tied to Atlanta, Georgia in the data we show; additional addresses may exist on the full record.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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