DR. THEODORE MARK DANGER – Certified Registered Nurse Anesthetist, NPI 1104440783

DR. THEODORE MARK DANGER is a healthcare provider. based in Plymouth, Minnesota. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 2482206 (MN). The NPI Number for DR. THEODORE MARK DANGER is 1104440783

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. THEODORE MARK DANGER
NPI
1104440783
Phone
(763) 559-3779
Address
PO BOX 47159
Enumeration Date
30 May 2020
Last Update Date
29 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9524567100
Graduation Year
2020 (6 years ago)
PAC ID
0941628168
Group Practice PAC ID
6709842461
Professional Enrollment ID
I20200918002336
Address ID
MN551211002EA2700XCIRX302
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:6State licenses:2Digital endpointsOther names

2,131 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MN

Provider Addresses for DR. THEODORE MARK DANGER

  • PO BOX 47159

    PLYMOUTH, MN 554470159

    Phone: (763) 559-3779

    Fax: (763) 450-3986

    Type: Mailing

  • 14700 28TH AVE N STE 20

    PLYMOUTH, MN 554474876

    Phone: (763) 559-3779

    Fax: (763) 450-3986

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-09-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200918002336ICertified Registered Nurse Anesthetist (Crna)MNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55447)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6709842461View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
A N E S T H E S I O L O G YMN
A N E S T H E S I O L O G YMN
-MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN

Reviews

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Frequently asked questions

How do I look up DR. THEODORE MARK DANGER by NPI?
Use NPI 1104440783 when you need to reference DR. THEODORE MARK DANGER in forms, claims, or directories.
Does this profile mean DR. THEODORE MARK DANGER is currently active?
Yes — DR. THEODORE MARK DANGER appears active in the national provider directory.
Does DR. THEODORE MARK DANGER list a primary specialty?
If you are matching referrals, note Certified Registered Nurse Anesthetist for DR. THEODORE MARK DANGER. Clinical services aligned with this taxonomy classification.
What location shows for DR. THEODORE MARK DANGER?
We surface Plymouth, Minnesota for DR. THEODORE MARK DANGER based on available NPPES addresses.
Is DR. THEODORE MARK DANGER a real provider?
This page reflects official NPPES data for NPI 1104440783. Always confirm identity and privileges with the practice and licensing boards.

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