Theodore E Yaeger IV, M.D.

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

ME43556 Issued in FL

Practice address

1620 Mason Ave Ste E
Daytona Beach, FL 32117-5513

Phone

(386) 506-5115

NPI assigned

Apr 10, 2006

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 FL

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

Specialty

Radiation Oncology

Education

Hahnemann University College of Medicine, 1981

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Urology Institute LLCGroup PAC ID 2163653585, 152 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/uc41222_advuroswflorida

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

• Advanced Urology Institute, LLC

  • Urology Physician
  • Oxford, FL
  • NPI 1023447935
  Medicare reassignment Care Compare group NPD
• Radiation Oncology Associates of Central Florida,PA

  • Radiation Oncology Physician
  • Daytona Beach, FL
  • NPI 1003879099
  NPD (past) Authorized official
• Advanced Urology Institute, LLC

  • Durable Medical Equipment & Medical Supplies
  • Inverness, FL
  • NPI 1700024163
  NPD
• Wake Forest University Health Sciences

  • Multi-Specialty Clinic/Center
  • Winston Salem, NC
  • NPI 1003803032
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784246400000",
    "number": "1700849783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 MASON AVE STE E",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175513",
            "telephone_number": "386-506-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 MASON AVE STE E",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175513",
            "telephone_number": "386-506-5115"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Medical Center Blvd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271570001",
            "country_code": "US",
            "telephone_number": "336-716-2255",
            "fax_number": "336-713-6622",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YAEGER",
        "first_name": "THEODORE",
        "middle_name": "E",
        "name_suffix": "IV",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2026-07-17",
        "certification_date": "2026-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "FL",
            "license": "ME43556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5906556",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl J Wynn, DPT
• Julianne M Wysocki Broadwater, D.O.
• Yifan Xing
• Katerina Xu, PHARMD
• Donna C Xynidis, MS, SLP
• Mehran Yaghmaie, MD
• Itsuko Yamaguchi, M.S., ATC, LAT
• Joseph Fayez Yanni, AGACNP-BC
• Rachel Waesche Yarbrough, MD
• Lisandra Yero, DMD

• Radiation Oncology Physician in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Radiation Oncology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.