DAVID A DASSENKO (MD) – Critical Care Medicine (Anesthesiology) Physician, NPI 1104865716

DAVID A DASSENKO (MD) is a healthcare provider. based in Plymouth, Minnesota. specializing in PEDIATRIC MEDICINE, ANESTHESIOLOGY, CRITICAL CARE (INTENSIVISTS). They hold the professional credentials MD. They hold a License No. 25521 (MN). The NPI Number for DAVID A DASSENKO (MD) is 1104865716

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
DAVID A DASSENKO (MD)
NPI
1104865716
Phone
(763) 559-3779
Address
PO BOX 47159
Enumeration Date
6 June 2006
Last Update Date
27 December 2010

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7632366786
Graduation Year
1979 (47 years ago)
PAC ID
8123081262
Group Practice PAC ID
5698689123
Professional Enrollment ID
I20041109000887
Address ID
MN554332522CO4050XNWXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

717 PEDIATRIC MEDICINE in MN

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Provider Addresses for DAVID A DASSENKO (MD)

  • The Box, Tavistock Place, Barbican, Plymouth, South West England, England, PL4 8AU, United Kingdom

    PLYMOUTH, MN 554470159

    Phone: (763) 559-3779

    Fax: (763) 450-3986

    Type: Mailing

  • Chicago Av, Washington Avenue South, Minneapolis, Hennepin County, Minnesota, 55415:55454, United States

    MINNEAPOLIS, MN 554044518

    Phone: (612) 813-6000

    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: 2004-11-09

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
I20041109000887IPediatric MedicineMNTBD

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: 5698689123View full group profile
NameSpecialtyState
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
Certified Registered Nurse Anesthetist (Crna)MN
-MN
-MN
-MN
-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

Reviews

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Frequently asked questions

Where can patients find DAVID A DASSENKO (MD)'s NPI?
You can confirm DAVID A DASSENKO (MD) with NPI 1104865716; it appears in the national provider directory.
Is DAVID A DASSENKO (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DAVID A DASSENKO (MD)'s specialty in plain language?
Clinically, the directory lists DAVID A DASSENKO (MD) with Critical Care Medicine (Anesthesiology) Physician. Clinical services aligned with this taxonomy classification.
Where is DAVID A DASSENKO (MD)'s primary listing?
We display Plymouth, Minnesota because that is what the record indicates for DAVID A DASSENKO (MD).
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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