2026 NPPES data General Practice Physician NPI 1518985043 MD
Verify on CMS →

DANIEL THEODORO, MD

General Practice Physician in SAINT LOUIS, Missouri. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
74
Medicare Part D claims · 51 beneficiaries · General Practice Physician avg: 3K
MIPS score
79.292/100
▼ 4 pts below national avg 83.1 · [object Object]
Industry payments
$33.59
2 payments · CMS Open Payments (Sunshine Act)
What the federal data reveals: DANIEL THEODORO, MD is a General Practice Physician ([object Object]) practicing in SAINT LOUIS, Missouri with a Medicare Part D prescribing footprint of 74 claims across 51 beneficiaries . Their CMS MIPS Final Score of 79.292/100 (national average: 83.1) reflects performance across Quality, Cost, Interoperability, and Improvement Activities . Industry payments of $33.59 across 2 transactions are disclosed under CMS Open Payments (Sunshine Act).

What stands out: DANIEL THEODORO, MD reported a CMS MIPS final score of 79.292 out of 100, below the 83.1 national average, and filed 74 Medicare Part D claims in 2023. Every figure on this page comes straight from federal CMS records, with no proprietary rating applied.

Board certification likely (heuristic — not verified)

DANIEL THEODORO, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting + 1 hospital affiliation — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

DANIEL THEODORO, MD at a glance

Near national average

NPI registry status

Active

Issued 07/17/2006

NPI 1518985043

Primary specialty

General Practice Physician

Mid-sized

16,677 US NPIs in this specialty

Medicare Part D claims

74 97% vs specialty avg

2023 prescription claims

Specialty avg: 2,872

MIPS final score

79.292/100 3.8079999999999927% pts

Above neutral band

vs 83.1 national avg

Specialty distribution in Missouri

How General Practice Physician compares to other specialties among Missouri providers

Missouri providers

General Practice Physician share within Missouri

1. General Practice Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
General Practice Physician share within Missouri

Medicare quality performance — MIPS

DANIEL THEODORO, MD's 2023 MIPS final score plotted against the General Practice Physician national average

Near national average
MIPS Final Score
79.292/100
vs 83.1 national avg · 2023 performance year

MIPS final score (General Practice Physician) — 79.292/100 vs national avg 83.1

0%100%National avg83%79.3%
MIPS final score (General Practice Physician) — 79.292/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

DANIEL THEODORO, MD is a General Practice Physician provider practicing in SAINT LOUIS, Missouri, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1518985043. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

DANIEL THEODORO, MD appears in the CMS NPPES registry as a General Practice Physician provider holding MD credentials at 400 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO, 63110, with a listed phone of (314) 362-9123. NPI 1518985043 was issued on 07/17/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what THEODORO most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 74 prescription claims written by this provider, covering 51 Medicare beneficiaries and totaling roughly $3K in drug spend, with an opioid prescribing rate of 24.3%. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 79.292/100 for the 2023 performance year (Quality 71.46, Cost 59.5132), compared with the national average of 83.1.

General Practice Physician is a mid-sized specialty nationwide, with 16,677 enrolled providers across 56 states and an average of 2,872 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

400 S KINGSHIGHWAY BLVD
SAINT LOUIS, MO 63110

Provider Details

NPI 1518985043
Specialty General Practice Physician
Credentials MD
Gender Male
NPI Issued 07/17/2006

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

79.292
Final Score
Avg: 83.1
71.46
Quality
59.5132
Cost
100
Promoting Interoperability

Reporting: Group practice

Hospital and facility affiliations

Facilities where DANIEL THEODORO, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

WASHINGTON UNIVERSITY
SAINT LOUIS, MO

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Industry payments received (2024) — CMS Open Payments transparency data

The federal Physician Payments Sunshine Act (part of the Affordable Care Act) requires drug and medical-device manufacturers + group purchasing organizations to publicly report payments and other transfers of value to physicians and teaching hospitals. The data below covers 2024 for DANIEL THEODORO, MD. Source: openpaymentsdata.cms.gov.

Total received

$34

Largest payer

Teleflex LLC

Most common payment type

Food and Beverage

Industry payments are not necessarily indicators of bias — they include research funding, consulting fees for evidence-based work, royalties for inventions, food at conferences, and similar items. The disclosure exists for transparency. Read our methodology for how we interpret this data.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

74
Total Claims
$3K
Total Drug Cost
51
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
79
Total Day Supply
1,045
Generic Drug Cost
$595
Opioid Claims
18 (24.3% rate)
Antibiotic Claims
11

Patient Demographics

Average Patient Age
70.9 years
Avg HCC Risk Score
1.70
Gender Split
49% female / 51% male

General Practice Physician Overview

How DANIEL THEODORO, MD fits within the General Practice Physician landscape nationally.

16,677
General Practice Physician Providers in US
56
States with General Practice Physician
2,872
Avg Claims per Provider

DANIEL THEODORO, MD's 74 claims are below the specialty average of 2,872.

Nearby General Practice Physician Providers in Missouri

Other clinicians with the same primary specialty enrolled in Missouri, drawn from the same CMS NPPES roster as THEODORO.

Compare General Practice Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is DANIEL THEODORO, MD's specialty?
DANIEL THEODORO, MD specializes in General Practice Physician and practices in SAINT LOUIS, Missouri. Credentials: MD.
How much does DANIEL THEODORO, MD prescribe under Medicare Part D?
In 2023, DANIEL THEODORO, MD wrote 74 Medicare Part D claims totaling $3K in drug costs for 51 beneficiaries.
What is DANIEL THEODORO, MD's Medicare quality score?
DANIEL THEODORO, MD has a CMS MIPS Final Score of 79.292/100 (Quality: 71.46, Cost: 59.5132). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is DANIEL THEODORO, MD located?
DANIEL THEODORO, MD is located at 400 S KINGSHIGHWAY BLVD, SAINT LOUIS, MO, 63110. Phone: (314) 362-9123.
What is DANIEL THEODORO, MD's NPI number?
DANIEL THEODORO, MD's National Provider Identifier (NPI) is 1518985043, issued on 07/17/2006.
Does DANIEL THEODORO, MD prescribe opioids?
Yes, DANIEL THEODORO, MD had 18 opioid claims in 2023 with an opioid prescribing rate of 24.3%.
How many General Practice Physician providers are there in the US?
There are 16,677 General Practice Physician providers across 56 states in the US. The average General Practice Physician provider writes 2,872 Medicare Part D claims per year.
Does DANIEL THEODORO, MD accept Medicare?
DANIEL THEODORO, MD appears in CMS Medicare data with 74 Part D claims and 51 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify DANIEL THEODORO, MD's credentials?
DANIEL THEODORO, MD's NPI is 1518985043 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology