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DR. THEODORE SETH THOMAS MD
NPI 1326359837
Internal Medicine - Medical Oncology in Saint Louis, MO

Active since June 30, 2010PECOS EnrolledAccepts Medicare Assignment
92.39/100
CMS Quality Rating
915 N GRAND BLVD, SAINT LOUIS, MO 63106(314) 652-4100 Get Directions Write a Review

NPPES record last updated: February 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Theodore Seth Thomas Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THEODORE SETH THOMAS MD (NPI 1326359837) is an individual medical oncology provider in Saint Louis, Missouri, licensed in Illinois (036166718) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Memorial Hospital, and maintains a secondary practice location in Shiloh.

NPPES Registry Identity

NPI1326359837
Entity TypeIndividualMale
Primary Taxonomy207RX0202X
Provider Legal NameDR. THEODORE SETH THOMASCredential: MD
Location Address915 N GRAND BLVDSaint Louis, MO 63106-1621
Mailing Address915 N Grand BlvdSaint Louis, MO 63106-1621 · (314) 652-4100 · Fax (314) 289-6320
Phone(314) 652-4100
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Columbia School Of MedicineGraduated 2010
Enumeration DateJune 30, 2010
Last NPPES UpdateFebruary 3, 2026
NPPES CertifiedFebruary 3, 2026
✔ NPI 1326359837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Medical OncologyAllopathic & Osteopathic Physicians
Taxonomy Code207RX0202X
License✔ Licensed in IL · 036166718
Definition
An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer.
Also ListedInternal MedicineTaxonomy 207R00000X · License 036166718 (IL)
915 N GRAND BLVD, Saint Louis, MO 63106
Open in Google Maps ↗

Secondary Practice Location 1

Location 11418 Cross St, Div IM Medical Oncology, Ste 180Shiloh, IL 62269-2914 · Phone (800) 647-2098 · Fax (314) 362-3192

Other Identifiers 1

Medicaid200008314MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cox HealthPlans.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Theodore Seth Thomas Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2860635380
PECOS Enrollment IDI20240105003998
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
128 services25 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
47 services18 patients
New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205
This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.
21 services21 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
15 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Memorial Hospital

Acute Care Hospitals · Belleville, IL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number140185
Location4500 Memorial DriveBelleville, IL 62226 · St. Clair County
Emergency services Birthing friendly

Barnes Jewish Hospital

Acute Care Hospitals · Saint Louis, MO
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number260032
LocationOne Barnes-Jewish Hospital PlazaSaint Louis, MO 63110 · St. Louis City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63106 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$169.38 typical visit price
range $55.65 – $169.38
Typical copayment $42.34 (range $13.91 – $42.34)
Most-billed visit code 99205
Established Patient
$98.37 typical visit price
range $17.76 – $137.92
Typical copayment $24.59 (range $4.44 – $34.48)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

92.39/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality97.81
Promoting Interoperability100
Improvement Activities40
Cost70.26

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MATTHEW CHRISTOPHER SIMPSON O.D.
Optometrist
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
MS. CHARMIN MEYATTA GIBSON M.S.W.
Social Worker
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4110
CONOR MCCARTNEY M.D.
Internal Medicine
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
ALITA BILLOPS CNP
Nurse Practitioner (Primary Care)
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
STEPHANIE ADAMS
Registered Nurse
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 289-7676
NAGLA ABDELMALEK M.D.
Emergency Medicine
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
DR. JAMES MICHAEL HASIK DDS
Dentist (General Practice)
915 N GRAND BLVD, DENTAL CLINIC
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100
MS. TRACY LANES CRNA
Nurse Anesthetist, Certified Registered
915 N GRAND BLVD
SAINT LOUIS, MO 63106
St. Louis City (314) 652-4100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Theodore Thomas's NPI number?

The NPI number for Theodore Thomas is 1326359837. It was assigned to this individual provider in the NPPES registry on June 30, 2010.

Where is Theodore Thomas located?

Theodore Thomas practices at 915 N Grand Blvd, Saint Louis, MO 63106. The listed phone number is (314) 652-4100.

What is Theodore Thomas's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Medical Oncology, with taxonomy code 207RX0202X.

Is Theodore Thomas enrolled in Medicare?

Yes. Theodore Thomas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Theodore Thomas accept?

Health plans from Cox HealthPlans list Theodore Thomas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Theodore Thomas affiliated with any hospitals?

According to CMS data, Theodore Thomas is affiliated with Memorial Hospital and Barnes Jewish Hospital.

When was this NPI record last updated?

The NPPES record for Theodore Thomas was last updated on February 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.