DR. LISA G. DISTEFANO (M.D.) – Internal Medicine Physician, NPI 1003810789
Internal Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,289 INTERNAL MEDICINE in KS
Provider Addresses for DR. LISA G. DISTEFANO (M.D.)
12541 FOSTER ST STE 300
OVERLAND PARK, KS 662132304
Phone: (913) 317-3200
Fax: (913) 317-3218
Type: Mailing
East South Hills Drive, Maryville, Nodaway County, Missouri, 64468, United States
MARYVILLE, MO 644682659
Phone: (660) 562-2525
Fax: (660) 562-4303
Type: Mailing
Mosaic Medical Center - Maryville, 2016, South Main Street, Maryville, Nodaway County, Missouri, 64468, United States
MARYVILLE, MO 644682655
Phone: (660) 562-2525
Fax: (660) 562-7993
Type: Location
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: 2024-11-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20241106001845 | I | Internal Medicine | KS | TBD |
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.
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 66213)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Hospitalist, Internal Medicine | MO | |
| Diagnostic Radiology | MO | |
| Nurse Practitioner | MO | |
| Internal Medicine | MO | |
| Cardiovascular Disease (Cardiology) | KS | |
| Family Practice | MO | |
| Hospitalist, Internal Medicine | MO | |
| - | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| - | MO |
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