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

Dr. Theodore L Vander Velde, MD

Individual provider Diagnostic Radiology Physician · NPI 1417967068

Dr. Theodore L Vander Velde, MD is a Diagnostic Radiology in Saint Louis, Missouri. Graduated from Wayne State University School of Medicine in 1993, 33 years ago. Practices with Washington University, a 2,986-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
33
Trained at
Wayne State University School of Medicine
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

510 S Kingshighway Blvd Dept Radiology
Saint Louis, MO 63110-1016
Phone: (314) 362-7200
Fax: (314) 747-4189
Show map & directions

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

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 103886 (MO)

Record details

NPI number1417967068
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 8, 2006
Last updated in NPPESApril 17, 2025

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolWAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduated 1993 (33 years in practice)
Group practice Washington University — 2986 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations14 on file with Medicare

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