Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. David A Theodoro, MD

Individual provider Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician · NPI 1073518577

Dr. David A Theodoro, MD is a Thoracic Surgery in Bridgeton, Missouri. Graduated from Washington University School of Medicine in 1988, 38 years ago. Practices with St Dominic Medical Associates LLC, a 127-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois, Missouri and Mississippi.

Years since qualifying
38
Trained at
Washington University School of Medicine
Licensed in
IL, MO, MS
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

12255 De Paul Dr N Bldg Ste 260
Bridgeton, MO 63044
Phone: (314) 647-8269
Fax: (314) 646-1700
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 970 Lakeland Dr Ste 61, Jackson, MS 39216-4634 — (601) 200-2780

Specialties & licences

Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician (primary) Taxonomy 208G00000X · Licence 28104 (MS)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence 118293 (MO)
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician Taxonomy 208G00000X · Licence 036095641 (IL)

Record details

NPI number1073518577
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 20, 2005
Last updated in NPPESAugust 27, 2020
Certification dateAugust 27, 2020
Mailing addressPo Box 23666, Jackson, MS 39225-3666

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyTHORACIC SURGERY
Medical schoolWASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated 1988 (38 years in practice)
Group practice St. Dominic Medical Associates Llc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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