Dr David A Theodoro, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Bridgeton, Missouri. His current practice location is
12255 De Paul Dr North Bldg, Ste 260, Bridgeton, Missouri. You can reach out to his office (for appointments etc.) via phone at
(314) 647-8269.
Dr David A Theodoro is licensed to practice in Mississippi (license number 28104) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1073518577.
Physician's Profile
| Full Name | Dr David A Theodoro |
|---|
| Gender | Male |
|---|
| Speciality | |
|---|
| Experience | Years |
|---|
| Location | 12255 De Paul Dr North Bldg, Bridgeton, Missouri |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr David A Theodoro attended and graduated from in
NPI Data:
- NPI Number: 1073518577
- Provider Enumeration Date: 06/20/2005
- Last Update Date: 08/27/2020
Medicare PECOS Information:
- PECOS PAC ID:
- Enrollment ID:
Medical Identifiers
Medical identifiers for Dr David A Theodoro such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1073518577 | NPI | - | NPPES |
| 036056372 | Other | IL | SUBSTANCE CONTROL |
| 0360957641 | Medicaid | MO | |
| 1102596 | Other | MO | BNDD |
| 036056372 | Other | IL | LICENSE |
| 118293 | Other | MO | LICENSE |
| 036095641 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 118293 (Missouri) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 036095641 (Illinois) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 28104 (Mississippi) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr David A Theodoro is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr David A Theodoro, MD
Po Box 23666,
Jackson, MS 39225-3666
Ph: (601) 200-2780 | Dr David A Theodoro, MD
12255 De Paul Dr North Bldg, Ste 260,
Bridgeton, MO 63044
Ph: (314) 647-8269 |
Reviews and Comments