Individual provider Active NPI

Eric Mbugua Thuo, MD

  • General Practice Physician
  • Towson, MD
National Provider Identifier
1144857509
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
2024044118 Issued in MO
Practice address
6701 N Charles St
Towson, MD 21204-6881
Phone
(443) 849-2000
NPI assigned
Mar 25, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Physician 208D00000X 2024044118 MO Primary

Addresses

Primary practice location

6701 N Charles St
Towson, MD 21204-6881

Mailing address

3939 W Pine Blvd Apt 420
Saint Louis, MO 63108-3272
Phone (443) 630-7853

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20250325000844 MO Practitioner - General Practice 2264862523 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southeastern Physician Services PCGroup PAC ID 0042307852, 591 clinicians

Practice addresses (Care Compare)

10 Hospital Dr
Saint Peters, MO 63376-1659
Phone (800) 501-9855

11133 Dunn Rd
Saint Louis, MO 63136-6163
Phone (314) 653-4450

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2024044118MOMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signify Health, LLC General Practice CurrentSince Jan 11, 2025 Accepting new patients
Southeastern Physician Services PC CurrentSince Sep 1, 2025 Accepting new patients

Locations

2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767

10 Hospital Dr
Saint Peters, MO 63376
Phone (636) 394-2522

4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037

4055 Valley View Ln
Ste 700
Dallas, TX 75244
Phone (469) 466-7424

Organizations & group practices 2

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

Hospital & facility affiliations 2

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": "1585094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1144857509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3939 W PINE BLVD APT 420",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631083272",
            "telephone_number": "443-630-7853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6701 N CHARLES ST",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212046881",
            "telephone_number": "443-849-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUO",
        "first_name": "ERIC",
        "middle_name": "MBUGUA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-25",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MO",
            "license": "2024044118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.