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THEODORE A DANIEL JR. MD
NPI 1689641615
Pediatrics in Saint Clair Shores, MI

Active since March 08, 2006PECOS Enrolled
20225 E 9 MILE RD, SUITE A, SAINT CLAIR SHORES, MI 48080(586) 772-1090(586) 772-4366 Get Directions Write a Review

NPPES record last updated: April 7, 2014. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Theodore A Daniel Jr. Md NPPES

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

THEODORE A DANIEL JR. MD (NPI 1689641615) is an individual pediatrics provider in Saint Clair Shores, Michigan, licensed in Michigan (4301047561) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689641615
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameTHEODORE A DANIEL JR.Credential: MD
Location Address20225 E 9 MILE RD, SUITE ASaint Clair Shores, MI 48080-1775
Mailing Address20225 E 9 Mile Rd, Suite ASaint Clair Shores, MI 48080-1775 · (586) 772-1090 · Fax (586) 772-4366
Phone(586) 772-1090
Fax(586) 772-4366
Sole ProprietorNo
Enumeration DateMarch 8, 2006
Last NPPES UpdateApril 7, 2014
✔ NPI 1689641615 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 4301047561
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
20225 E 9 MILE RD, Saint Clair Shores, MI 48080
Open in Google Maps ↗

Other Identifiers 2

Medicaid4373576MI
Medicare UPINE68064MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Theodore A Daniel Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignment

Medicare enrollment records show Theodore Daniel reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Henry Ford Cornerstone Medical Group
11 mi
Family Medicine
43900 GARFIELD RD STE 222
Clinton Township, MI 48038
  • Reassigned Medicare billing, Michigan enrollment
  • 87 clinicians in this Medicare group
NPI 1851765374 (586) 286-0050

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48080 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$102.35 typical visit price
range $18.32 – $143.49
Typical copayment $25.58 (range $4.58 – $35.87)
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.

Other Providers at the Same Location NPPES 19

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

RUBIN PETER GAPPY MD
Pediatrics
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 772-1090
GIUSEPPINA LOMBARDO NAUGHTON DO
Pediatrics
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 772-1090
BARBARA CLARE TESS MD
Family Medicine
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 779-8700
DAVID WALTER KROLL MD
Pediatrics
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 772-1090
CHRISTOPHER S GOLDSBY MD
Family Medicine
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 779-8700
KENDRA HELENE MOTYL M.D.
Pediatrics
20225 E 9 MILE RD
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 772-1090
DR. PAUL PADESKY M.D.
Pediatrics
20225 E 9 MILE RD, SUITE A
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 772-1090
CECELIA KITAKUFE M.D.
Family Medicine
20225 E 9 MILE RD
SAINT CLAIR SHORES, MI 48080
Macomb County (586) 779-8700

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 Theodore Daniel's NPI number?

The NPI number for Theodore Daniel is 1689641615. It was assigned to this individual provider in the NPPES registry on March 8, 2006.

Where is Theodore Daniel located?

Theodore Daniel practices at 20225 E 9 Mile Rd Suite A, Saint Clair Shores, MI 48080. The listed phone number is (586) 772-1090.

What is Theodore Daniel's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Theodore Daniel enrolled in Medicare?

Yes. Theodore Daniel is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Theodore Daniel's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Theodore Daniel reassigns Medicare benefits to Henry Ford Cornerstone Medical Group (Clinton Township, MI). The 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 Theodore Daniel's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Theodore Daniel accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 1 other insurer list Theodore Daniel 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.

When was this NPI record last updated?

The NPPES record for Theodore Daniel was last updated on April 7, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.