Individual provider Active NPI

Thomas John Gniadek, MD PHD

  • Anatomic Pathology & Clinical Pathology Physician
  • Saint Louis, MO
National Provider Identifier
1205101334
Registry record updated Jan 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
2024018547 Issued in MO
Practice address
1402 S Grand Blvd
Saint Louis, MO 63104-1004
Phone
(314) 617-2000
NPI assigned
Mar 22, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 036145372 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036145372 IL
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 2024018547 MO Primary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 2024018547 MO

Addresses

Primary practice location

1402 S Grand Blvd
Saint Louis, MO 63104-1004

Mailing address

844 Knollwood Rd
Deerfield, IL 60015-3313
Phone (203) 806-0125

Other practice location 1

300 S 6th St # Mc604
Minneapolis, MN 55487-0999
Phone (612) 596-1036

Other practice location 2

844 Knollwood Rd
Deerfield, IL 60015-3313
Phone (203) 806-0125

Other practice location 3

2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone (612) 813-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, MO2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20170522001227 MN Practitioner - Pathology 8022269729 Reassigns benefits to 1 organization
I20251209004287 MO Practitioner - Pathology 8022269729 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hennepin Healthcare System IncGroup PAC ID 4789684861, 905 clinicians

Practice addresses (Care Compare)

701 Park Ave
Minneapolis, MN 55415-1623
Phone (612) 873-6963

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036145372ILMDBlood Banking & Transfusion Medicine Physician
2024018547MOMDBlood Banking & Transfusion Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group Anatomic Pathology & Clinical Pathology CurrentSince Dec 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Dec 1, 2025 Accepting new patients
Hennepin Healthcare System, Inc CurrentSince May 1, 2025 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Hennepin Healthcare System Inc CurrentSince May 1, 2025 Accepting new patients
Endeavor Health Medical Group Blood Banking & Transfusion Medicine PastSince Apr 24, 2018 Accepting new patients

Locations

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

701 Park Ave
#350
Minneapolis, MN 55415
Phone (612) 873-5334

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1402 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 577-8762

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1332374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767744000000",
    "number": "1205101334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "844 KNOLLWOOD RD",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153313",
            "telephone_number": "203-806-0125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-617-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 S 6th St # Mc604",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554870999",
            "country_code": "US",
            "telephone_number": "612-596-1036",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "844 Knollwood Rd",
            "address_purpose": "LOCATION",
            "city": "Deerfield",
            "state": "IL",
            "postal_code": "600153313",
            "country_code": "US",
            "telephone_number": "203-806-0125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2525 Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554044518",
            "country_code": "US",
            "telephone_number": "612-813-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GNIADEK",
        "first_name": "THOMAS",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-22",
        "last_updated": "2026-01-07",
        "certification_date": "2026-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "IL",
            "license": "036145372",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036145372",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MO",
            "license": "2024018547",
            "primary": true
        },
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "MO",
            "license": "2024018547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.