Active NPI
Thomas Edward Conturo, MD, PHD
- Neuroradiology Physician
- Saint Louis, MO
National Provider Identifier
1083366264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neuroradiology Physician
- License
- 104463
- Practice address
- 4567 W Pine Blvd Apt 312
Saint Louis, MO 63108-2175 - Phone
- (314) 288-6580
- Fax
- (412) 422-9876
- NPI assigned
- Jan 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | 104463 | MO | Primary |
Addresses
Primary practice location
4567 W Pine Blvd Apt 312
Saint Louis, MO 63108-2175
Mailing address
4567 W Pine Blvd Apt 312
Saint Louis, MO 63108-2175
Phone (314) 288-6580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 104463 | MO | MD | Neuroradiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1760054400000",
"number": "1083366264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4567 W PINE BLVD APT 312",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082175",
"telephone_number": "314-288-6580",
"fax_number": "412-422-9876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4567 W PINE BLVD APT 312",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631082175",
"telephone_number": "314-288-6580",
"fax_number": "412-422-9876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONTURO",
"first_name": "THOMAS",
"middle_name": "EDWARD",
"credential": "MD, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-01-19",
"last_updated": "2025-10-10",
"certification_date": "2025-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "MO",
"license": "104463",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.