DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) – Neuropathology Physician, NPI 1609295781

DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) is a healthcare provider. based in Boston, Massachusetts. specializing in PATHOLOGY. They hold the professional credentials M.D., PH.D.. They hold a License No. 64362 (CT). The NPI Number for DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) is 1609295781

Main info

Male
12 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.)
NPI
1609295781
Phone
(617) 732-7510
Address
75 FRANCIS ST
Enumeration Date
15 April 2014
Last Update Date
2 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2036882433
Graduation Year
2014 (12 years ago)
PAC ID
6800144122
Group Practice PAC ID
9436061736
Professional Enrollment ID
I20201215000967
Address ID
CT065103220NE20XXXSTXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

323 PATHOLOGY in CT

Provider Addresses for DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.)

  • 75 FRANCIS ST

    BOSTON, MA 021156110

    Phone: (617) 732-7510

    Fax: (617) 277-9015

    Type: Mailing

  • 310 CEDAR ST

    NEW HAVEN, CT 065103218

    Phone: (203) 785-3624

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $107.

Total Amount is formed as General ($107) + Research ($0) + Ownership ($0) = $107.

Last reported payment date: 2023-04-24 • Largest payer in this snapshot: F. Hoffmann-La Roche AG ($107).

Total Amount

$107

General + Research + Ownership

Payments

1

Total payment records

General Amount

$107

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-04-24

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
F. Hoffmann-La Roche AG$107
View all Open Payments →|Open Payments Risk Radar →

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: 2020-12-15

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
I20201215000967IPathologyCTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
88307Pathology examination of tissue using a microscope, moderately high complexity2113$0
88342Special stained specimen slides to examine tissue, initial procedure1413$0
View full utilization report →

Insurance plans in this area (ZIP 02115)

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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: 9436061736View full group profile
NameSpecialtyState
Interventional Cardiology, Cardiovascular Disease (Cardiology)CT
H E M A T O L O G Y/ O N C O L O G YCT
Internal Medicine, NephrologySC
-CT
-NC
Internal MedicineCT
-CT
Cardiac SurgeryCT
-CT
-CT

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Frequently asked questions

What identifier follows DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) across health systems?
The NPI 1609295781 uniquely identifies DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) in U.S. healthcare data.
Is DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) currently accepting referrals based on NPI status?
Registry metadata lists DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) as active.
Which specialty label fits DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.)?
NPPES ties DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) to Neuropathology Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
Is DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) tied to Boston, Massachusetts?
If you are local to Boston, Massachusetts, DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.) may be relevant to your search.
Why is information missing for DR. MARCELLO MICHAEL JR. DISTASIO (M.D., PH.D.)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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