DR. THEODORE DAKE JR. M.D.
NPI 1073506234
Specialist in San Marcos, TX

NPI Status: Active since August 23, 2005

Contact Information

310 STAGECOACH TRL
SUITE 300
SAN MARCOS, TX
ZIP 78666
Phone: (512) 392-3398
Fax: (512) 392-2890

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  • Individual
  • Male
  • Specialist
  • PECOS Enrolled
  • Opted-Out Medicare

About THEODORE DAKE

This page provides the complete NPI Profile along with additional information for Theodore Dake, a provider established in San Marcos, Texas with a medical specialization in Specialist. The healthcare provider is registered in the NPI registry with number 1073506234 assigned on August 2005. The practitioner's primary taxonomy code is 174400000X with license number E9594 (TX). The provider is registered as an individual and his NPI record was last updated 19 years ago.

NPI
1073506234
Provider Name
DR. THEODORE DAKE JR. M.D.
Gender
Male
Entity Type
Individual
Location Address
310 STAGECOACH TRL SUITE 300 SAN MARCOS, TX 78666
Location Phone
(512) 392-3398
Location Fax
(512) 392-2890
Mailing Address
310 STAGECOACH TRL SUITE 300 SAN MARCOS, TX 78666
Mailing Phone
(512) 392-3398
Mailing Fax
(512) 392-2890
Is Sole Proprietor?
Yes
Enumeration Date
08-23-2005
Last Update Date
07-08-2007
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The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Theodore Dake opted out of Medicare effective on 10-01-2019 until 10-01-2027. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Specialist

Taxonomy Code
174400000X
Type
Other Service Providers
License No.
E9594
License State
TX
Taxonomy Description
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
8M0870OTHER (01)TXBLUE CROSS BLUE SHIELD
00FC30MEDICARE ID-TYPE UNSPECIFIED (04)TX 
B22098MEDICARE UPIN (02)TX 

Medicare Participation & PECOS Enrollment Status

Theodore Dake is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • Opted-Out of Medicare? Yes

  • Opt-Out Effective Date: 10-01-2019

  • Opt-Out End Date: 10-01-2027

  • Eligible to Order and Refer? Yes

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Reviews for DR. THEODORE DAKE JR. M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1073506234, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
3
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
2
Unchanged
Pos 9
3
Doubled → 6
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 6 → 12 → 3 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 4 + 3 + 1 + 0 + 0 + 1 + 2 + 2 + 6 + 24 = 46

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1073506234.

Other Providers at the Same Location


The following 7 providers are registered at the same or a nearby location.

Dentist (General Practice)
310 STAGECOACH TRL, STE 800
SAN MARCOS, TX 78666
Social Worker (Clinical)
310 STAGECOACH TRL, SUITE 300
SAN MARCOS, TX 78666
Dentist (Oral and Maxillofacial Surgery)
310 STAGECOACH TRL, SUITE 600
SAN MARCOS, TX 78666
Dentist (General Practice)
310 STAGECOACH TRL, SUITE 700
SAN MARCOS, TX 78666
General Practice
310 STAGECOACH TRL, SUITE 200 B
SAN MARCOS, TX 78666
Nurse Practitioner (Family)
310 STAGECOACH TRL, SUITE 200A
SAN MARCOS, TX 78666
Family Medicine (Adult Medicine)
310 STAGECOACH TRL, SUITE 200
SAN MARCOS, TX 78666

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073506234, enumerated as an "individual" on August 23, 2005.

The provider is located at 310 STAGECOACH TRL SUITE 300 SAN MARCOS, TX 78666 and the phone number is (512) 392-3398.

Specialist with taxonomy code 174400000X.

The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.