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

Dr. Gus Theodos, MD

Individual provider Interventional Cardiology Physician · NPI 1053401422

Dr. Gus Theodos, MD is an Interventional Cardiology in Saint Louis, Missouri. Graduated from Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University in 2003, 23 years ago. Practices with Physician Groups Lc, a 524-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
23
Trained at
Clvlnd Clinic Lerner College of Med of Case Wstn Rsv University
Licensed in
MO
In the registry since
2006
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

3023 N Ballas Rd Ste 200D
Saint Louis, MO 63131-2328
Phone: (314) 996-7272
Show map & directions

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

Specialties & licences

Interventional Cardiology Physician (primary) Taxonomy 207RI0011X · Licence 2016007344 (MO)

Record details

NPI number1053401422
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedOctober 13, 2006
Last updated in NPPESMarch 22, 2021
Certification dateMarch 22, 2021
Mailing address670 Mason Ridge Center Dr Ste 300, Saint Louis, MO 63141-8573

Medicare enrollment

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

Medicare specialtyINTERVENTIONAL CARDIOLOGY
Also practisesCARDIOVASCULAR DISEASE (CARDIOLOGY)
Medical schoolCLVLND CLINIC LERNER COLLEGE OF MED OF CASE WSTN RSV UNIVERSITY
Graduated 2003 (23 years in practice)
Group practice Physician Groups Lc — 524 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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