Gus Theodos, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

2016007344 Issued in MO

Practice address

3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328

Phone

(314) 996-7272

NPI assigned

Oct 13, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physician Groups LCGroup PAC ID 3072421254, 526 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
• Parkland Health Center Hospital, Farmington, MO, CCN 260163
• Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191
• Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
• Anderson Hospital Hospital, Maryville, IL, CCN 140289

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• IA HMO
• IA HMO C-SNP

Interoperability endpoints

• FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/
• Direct secure messaging: gtheodos289288@direct.carenet.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Saint Louis, MO
  • NPI 1285664268
  Medicare reassignment Care Compare group NPD
• Physician Groups LC

  • Multi-Specialty Clinic/Center
  • Farmington, MO
  • NPI 1427114990
  NPD
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barnes Jewish Hospital

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1649299827
  Care Compare affiliation
• Barnes Jewish St Peters Hospital Inc

  • General Acute Care Hospital
  • Saint Peters, MO
  • NPI 1144238908
  Care Compare affiliation
• Missouri Baptist Medical Center

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1487663506
  Care Compare affiliation
• Parkland Health Center

  • General Acute Care Hospital
  • Farmington, MO
  • NPI 1003824061
  Care Compare affiliation
• Parkland Health Center

  • Psychiatric Hospital Unit
  • Farmington, MO
  • NPI 1902814866
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1053401422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 MASON RIDGE CENTER DR STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3023 N BALLAS RD STE 200D",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631312328",
            "telephone_number": "314-996-7272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODOS",
        "first_name": "GUS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-13",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2016007344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2",
            "affiliation": "N",
            "endpointDescription": "BJC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3023 N Ballas Rd Ste 200D",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312328",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Danielle Thelen
• Mark William Thenhaus, DC
• Daniel L Theodoro, MD
• Leonidas Theodoro, MD
• Panayotis Christos Theodoropoulos, MD, PHD
• Therapeutic and Diagnostic Imaging LLC
• Therapeutic Innovations LC
• Therapeutic Specialties Inc
• Therapy Quarter, LLC
• Linda Therkildsen, DO

• Interventional Cardiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Interventional Cardiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.