Theodis Anthony Maltbia, MD

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

A186576 Issued in CA

Practice address

1402 S Grand Blvd # M260
Saint Louis, MO 63104-1004

Phone

(314) 977-9851

Fax

(314) 977-9852

NPI assigned

Mar 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Anesthesiology

Education

Saint Louis University School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Center Redding Hospital, Redding, CA, CCN 050280

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Cep America - Anesthesia, PC

  • Anesthesiology Physician
  • Walnut Creek, CA
  • NPI 1790401438
  Medicare reassignment Care Compare group NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Redding, CA
  • NPI 1013561851
  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Langhorne, PA
  • NPI 1093678229
  NPD
• Cep America - Anesthesia PC

  • Anesthesiology Physician
  • Fremont, CA
  • NPI 1982009759
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Redding, CA
  • NPI 1477671535
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1841759933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3244 HENRIETTA ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041308",
            "telephone_number": "217-418-1679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 S GRAND BLVD # M260",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041004",
            "telephone_number": "314-977-9851",
            "fax_number": "314-977-9852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2175 Rosaline Ave",
            "address_purpose": "LOCATION",
            "city": "Redding",
            "state": "CA",
            "postal_code": "960012549",
            "country_code": "US",
            "telephone_number": "530-768-1503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALTBIA",
        "first_name": "THEODIS",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A186576",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Maloney, MSW, LCSW
• Jillian Maloney, LPC
• McKenzie Elizabeth Maloney, MD
• Brigid Maltagliati, PTA
• Chloe Maltagliati
• Jessica Maltzman
• Horacio M Maluf, MD
• Gita J. Malur, M.D.
• Sheila Kiran Malusky, RNC, NNP
• Alisa Malutinok, RD,LD

• Anesthesiology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Anesthesiology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.