Theodore A Daniel Jr., MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301047561 Issued in MI

Practice address

20225 E 9 Mile Rd
Suite a
Saint Clair Shores, MI 48080-1775

Phone

(586) 772-1090

Fax

(586) 772-4366

NPI assigned

Mar 8, 2006

Last updated

Apr 7, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/mQjCqHb5rkr1u1foU4dqhQPBpi7Qk9R4/
• Direct secure messaging: theodore.daniel.2@8209.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Henry Ford Cornerstone Medical Group

  • Family Medicine Physician
  • Clinton Township, MI
  • NPI 1851765374
  Medicare reassignment NPD
• Ascension Macomb Oakland Hospital

  dba Michigan Neuro-Ophthalmology & Oculoplastic Surgery

  • Ophthalmology Physician
  • Madison Heights, MI
  • NPI 1114962461
  NPD (past)
• Thomas D Schomaker DO PC

  • Pediatrics Physician
  • Clinton Township, MI
  • NPI 1497906499
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396828800000",
    "number": "1689641615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-772-1090",
            "fax_number": "586-772-4366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20225 E 9 MILE RD",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801775",
            "telephone_number": "586-772-1090",
            "fax_number": "586-772-4366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANIEL",
        "first_name": "THEODORE",
        "middle_name": "A",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2014-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301047561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4373576",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra C Dadich, AUD
• Edouard R. Daher, M.D.
• Sandra L Daily, R.PH.
• Farzad Daneshvar, PHARMD
• Satyajit Daniel, MD
• Daniela Rodriguez MD PLC
• Kent Darcie, LLPC
• Taylor Darden
• Colton Darrow
• Sailaja Datla, MD

• Pediatrics Physician in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.