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DR. DANA WILLIAM PAPATHEODOROU M.D.
NPI 1588957971
Internal Medicine in Brandon, FL

Active since May 18, 2011PECOS EnrolledAccepts Medicare Assignment
57.93/100
CMS Quality Rating
119 OAKFIELD DR, BRANDON, FL 33511(855) 421-2733(321) 280-2479 Get Directions Write a Review

NPPES record last updated: May 18, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 18, 2020, Mar 29, 2017 (2 updates tracked since 2017).

About Dr. Dana William Papatheodorou M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DANA WILLIAM PAPATHEODOROU M.D. (NPI 1588957971) is an individual internal medicine provider in Brandon, Florida, licensed in New Jersey (25MA09507100) and active in the NPI registry since May 2011. He is enrolled in Medicare PECOS, is affiliated with Capital Health Medical Center - Hopewell, and is a graduate of Other (2011).

NPPES Registry Identity

NPI1588957971
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. DANA WILLIAM PAPATHEODOROUCredential: M.D.
Location Address119 OAKFIELD DRBrandon, FL 33511-5779
Mailing AddressPo Box 3637Brandon, FL 33509-3637
Phone(855) 421-2733
Fax(321) 280-2479
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateMay 18, 2011
Last NPPES UpdateMay 18, 20202 updates tracked since enumeration
NPPES CertifiedMay 18, 2020
✔ NPI 1588957971 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in NJ · 25MA09507100
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
119 OAKFIELD DR, Brandon, FL 33511
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Dana William Papatheodorou M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1759500077
PECOS Enrollment IDI20210915002176
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

4

Medicare enrollment records show Dana Papatheodorou reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

First Docs LLC
951 mi
Internal Medicine
1235 WHITEHORSE MERCERVILLE RD STE 306
Hamilton, NJ 08619
  • Reassigned Medicare billing, New Jersey enrollment
  • 39 clinicians in this Medicare group
NPI 1154936227 (609) 585-1122
Liberty Med Associates LLC
976 mi
Foot & Ankle Surgery
1 BETHANY RD STE 21
Hazlet, NJ 07730
  • Reassigned Medicare billing, New Jersey enrollment
  • 80 clinicians in this Medicare group
NPI 1386279552 (732) 264-8282
Hospitalist Physicians Of New Jersey PA
980 mi
Hospitalist
65 JAMES ST
Edison, NJ 08820
  • Reassigned Medicare billing, New Jersey enrollment
  • 351 clinicians in this Medicare group
NPI 1588021851 (732) 321-7000
Beacon Radiology Solutions LLC
994 mi
Diagnostic Radiology
94 OLD SHORT HILLS RD
Livingston, NJ 07039
  • Reassigned Medicare billing, New Jersey enrollment
  • Medicare enrollment name: Two River Physician Associates
  • 60 clinicians in this Medicare group
NPI 1417354333 (973) 322-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
814 services274 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
272 services127 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
202 services188 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
194 services183 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
25 services24 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Capital Health Medical Center - Hopewell

Acute Care Hospitals · Pennington, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310044
LocationOne Capital WayPennington, NJ 08534 · Mercer County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33511 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

57.93/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality68.21
Improvement Activities0
Cost51.37

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers13 claims13 services$51.73 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
1 supplier11 claims11 services$30.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SYED MUSTAFA ZAIDI
Internal Medicine
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (407) 788-1906
ROBERT MILLER AA
Anesthesiologist Assistant
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 658-5551
DR. SHAWN BLOUIN DNP, ARNP, AGACNP-BC
Nurse Practitioner
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 681-5551
AMANDA SUE ROGERS TURNER DO
Student in an Organized Health Care Education/Training Program
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 916-2358
DR. THOMAS STEVEN LEONARD MD
Emergency Medicine
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 681-5551
MR. ALBERTO RIOS PA-C
Physician Assistant (Medical)
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (800) 424-3672
DR. MATTHEW WILLIAM CARMAN M.D.
Emergency Medicine
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 681-5551
RICKI ANNE BROWN-FORESTIERE MD
Emergency Medicine
119 OAKFIELD DR
BRANDON, FL 33511
Hillsborough County (813) 916-2342

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Dana Papatheodorou's NPI number?

The NPI number for Dana Papatheodorou is 1588957971. It was assigned to this individual provider in the NPPES registry on May 18, 2011.

Where is Dana Papatheodorou located?

Dana Papatheodorou practices at 119 Oakfield Dr, Brandon, FL 33511. The listed phone number is (855) 421-2733.

What is Dana Papatheodorou's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Dana Papatheodorou enrolled in Medicare?

Yes. Dana Papatheodorou is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Dana Papatheodorou's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Dana Papatheodorou reassigns Medicare benefits to 4 organizations: First Docs LLC (Hamilton, NJ), Liberty Med Associates LLC (Hazlet, NJ), Hospitalist Physicians Of New Jersey PA (Edison, NJ) and Beacon Radiology Solutions LLC (Livingston, NJ). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dana Papatheodorou's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Dana Papatheodorou accept?

Health plans from Oscar Health list Dana Papatheodorou as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Dana Papatheodorou affiliated with any hospitals?

According to CMS data, Dana Papatheodorou is affiliated with Capital Health Medical Center - Hopewell.

When was this NPI record last updated?

The NPPES record for Dana Papatheodorou was last updated on May 18, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.