DR. THEODORE J ALEXANDER (DO) – Internal Medicine Physician, NPI 1053302877

DR. THEODORE J ALEXANDER (DO) is a healthcare provider. based in Canfield, Ohio. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 34002510A (OH). The NPI Number for DR. THEODORE J ALEXANDER (DO) is 1053302877

Main info

Male
57 Years Of Experience
Accepts Medicare Assignment
Name
DR. THEODORE J ALEXANDER (DO)
NPI
1053302877
Phone
(330) 758-4515
Address
4129 PEBBLE BEACH DR
Enumeration Date
1 November 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
3305537645
Graduation Year
1969 (57 years ago)
PAC ID
5890969695
Professional Enrollment ID
I20111112000019
Address ID
OH444069527CA4129XDRXX400
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

7,199 INTERNAL MEDICINE in OH

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Provider Addresses for DR. THEODORE J ALEXANDER (DO)

  • 4129, Pebble Beach Drive, Southern Hills, Canfield Township, Mahoning County, Ohio, 44406, United States

    CANFIELD, OH 444069527

    Phone: (330) 758-4515

    Fax: (330) 758-5121

    Mailing address matches the actual address.

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: 2011-11-12

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
I20111112000019IInternal MedicineOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only3433$0
View full utilization report →

Insurance plans in this area (ZIP 44406)

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Reviews

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Frequently asked questions

How is DR. THEODORE J ALEXANDER (DO) identified in CMS data?
CMS-hosted NPPES data lists DR. THEODORE J ALEXANDER (DO) with NPI 1053302877.
Can I rely on DR. THEODORE J ALEXANDER (DO) being an active provider?
As of the registry snapshot, DR. THEODORE J ALEXANDER (DO) is marked active.
What taxonomy line describes DR. THEODORE J ALEXANDER (DO)?
For research purposes, treat DR. THEODORE J ALEXANDER (DO) as Internal Medicine Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for DR. THEODORE J ALEXANDER (DO)?
DR. THEODORE J ALEXANDER (DO)'s geographic hint is Canfield, Ohio in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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