Individual provider Active NPI

Thomas Aquinas Kim, MD

  • Diagnostic Radiology Physician
  • Saint Louis, MO
National Provider Identifier
1063437333
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2021009685 Issued in MO
Practice address
510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016
Phone
(314) 362-7200
Fax
(314) 747-4189
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2021009685 MO Primary

Addresses

Primary practice location

510 S Kingshighway Blvd
Dept Radiology
Saint Louis, MO 63110-1016

Mailing address

PO Box 7412011
Chicago, IL 60674-2011
Phone (314) 362-7200

Other identifiers 1

IdentifierTypeStateIssuer
200094206MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Washington University

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO, IN3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20041020000588 IL Practitioner - Diagnostic Radiology 4385605658 Reassigns benefits to 1 organization
I20210420002447 MO Practitioner - Diagnostic Radiology 4385605658 Reassigns benefits to 2 organizations
I20220215002640 IN Practitioner - Diagnostic Radiology 4385605658 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Washington University School of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Miracl LLCGroup PAC ID 4587908041, 96 clinicians
Washington UniversityGroup PAC ID 9830008770, 2,968 clinicians

Practice addresses (Care Compare)

1000 GW LN
Waynesville, MO 65583-2339
Phone (573) 842-4000

1000 W 10TH St
Phelps Health
Rolla, MO 65401-2905
Phone (573) 364-9000

1050 W 10TH St
Rolla, MO 65401-2905
Phone (573) 364-9000

1060 W 10TH St
Phelps Health Delbert Day Cancer Institute
Rolla, MO 65401-2905
Phone (855) 406-3324

510 S Kingshighway Blvd
Saint Louis, MO 63110-1016
Phone (314) 362-7200

Hospital & facility affiliations

  • Barnes Jewish Hospital Hospital, Saint Louis, MO, CCN 260032
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • Barnes-Jewish West County Hospital Hospital, Creve Coeur, MO, CCN 260162
  • Phelps County Regional Medical Center Hospital, Rolla, MO, CCN 260017
  • Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
2021009685MOMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Richland Memorial Hospital, Inc CurrentSince Apr 1, 2020 Accepting new patients
Indiana University Radiology Associates, Inc. Neuroradiology CurrentSince Feb 1, 2022 Accepting new patients
Miracl, LLC CurrentSince Jan 8, 2023 Accepting new patients
Richland Memorial Hospital, Inc Current Accepting new patients
Washington University Neuroradiology CurrentSince Jan 8, 2024 Accepting new patients
Gibson Community Hospital Association PastSince Nov 13, 2019 Accepting new patients

Locations

5924 Reliable Pkwy
Chicago, IL 60686

900 E Scott St
Olney, IL 62450
Phone (618) 345-1000

1201 Ricker Rd
Salem, IL 62881
Phone (618) 548-3194

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

1000 W 10th St
Rolla, MO 65401
Phone (573) 364-9000

510 S Kingshighway Blvd
Saint Louis, MO 63110
Phone (314) 362-0177

510 S Kingshighway Blvd
Fl 6
Saint Louis, MO 63110
Phone (314) 362-2900

660 S Euclid Ave
#8131
Saint Louis, MO 63110
Phone (314) 362-2809

Organizations & group practices 6

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.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1063437333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412011",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 S KINGSHIGHWAY BLVD",
            "address_2": "DEPT RADIOLOGY",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101016",
            "telephone_number": "314-362-7200",
            "fax_number": "314-747-4189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIM",
        "first_name": "THOMAS",
        "middle_name": "AQUINAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2025-04-17",
        "certification_date": "2022-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MO",
            "license": "2021009685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200094206",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "affiliationName": "Washington University",
            "address_1": "510 S Kingshighway Blvd",
            "address_2": "Dept Radiology",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631101016",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.