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DR. KAYKAY SAN DO
NPI 1134860802
Pediatrics in Saint Louis, MO

Active since April 05, 2022PECOS Enrolled
1465 S GRAND BLVD RM 2717, SAINT LOUIS, MO 63104(314) 577-5634(314) 577-5616 Get Directions Write a Review

NPPES record last updated: November 21, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 21, 2025, Nov 14, 2025, Apr 5, 2022 (3 updates tracked since 2022).

About Dr. Kaykay San Do NPPES

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

DR. KAYKAY SAN DO (NPI 1134860802) is an individual pediatrics provider in Saint Louis, Missouri, licensed in Missouri (2025038928) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1134860802
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. KAYKAY SANCredential: DO
Location Address1465 S GRAND BLVD RM 2717Saint Louis, MO 63104-1003
Mailing Address1465 S Grand Blvd Rm 2717Saint Louis, MO 63104-1003 · (314) 577-5634 · Fax (314) 577-5616
Phone(314) 577-5634
Fax(314) 577-5616
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateApril 5, 2022
Last NPPES UpdateNovember 21, 20253 updates tracked since enumeration
NPPES CertifiedNovember 21, 2025
✔ NPI 1134860802 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MO · 2025038928
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1465 S GRAND BLVD RM 2717, Saint Louis, MO 63104
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kaykay San Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103207329
PECOS Enrollment IDI20251120004104
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.

Medicare Billing Reassignment

Medicare enrollment records show Kaykay San reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ssm Cardinal Glennon Childrens Hospital
13 mi
Pediatrics
2927 S . KINGS HIGHWAY BLVD
Saint Louis, MO 63139
  • Reassigned Medicare billing, Missouri enrollment
  • Medicare enrollment name: Ssm Cardinal Glennon Children's Hospital
  • 414 clinicians in this Medicare group
NPI 1073568226 (314) 268-4070

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 63104 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
$86.32 typical visit price
range $55.65 – $169.38
Typical copayment $21.58 (range $13.91 – $42.34)
Most-billed visit code 99203
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.

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.

NINOSHKA MENDONCA MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
LESLIE J DAVIS D.O.
Pediatrics
1465 S GRAND BLVD RM 2717, 1465 SOUTH GRAND BLVD, RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
DOMINIC BISESI DO
Emergency Medicine
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 268-4070
CHRISTOPHER PATRICK CALLAHAN MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
AMANI FIRDOUZE ASHRAF MD
Pediatrics
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
MRS. ELIZABETH MCCARTER NOONAN M.D.
Pediatrics
1465 S GRAND BLVD RM 2717, 1465 SOUTH GRAND BLVD, RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
DR. LILIA BURNS MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634
DR. TASNIM CHOWDHURY MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD RM 2717
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5634

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 Kaykay San's NPI number?

The NPI number for Kaykay San is 1134860802. It was assigned to this individual provider in the NPPES registry on April 5, 2022.

Where is Kaykay San located?

Kaykay San practices at 1465 S Grand Blvd Rm 2717, Saint Louis, MO 63104. The listed phone number is (314) 577-5634.

What is Kaykay San's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kaykay San enrolled in Medicare?

Yes. Kaykay San is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kaykay San's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kaykay San reassigns Medicare benefits to Ssm Cardinal Glennon Childrens Hospital (Saint Louis, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kaykay San's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kaykay San accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 4 other insurers list Kaykay San 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.

When was this NPI record last updated?

The NPPES record for Kaykay San was last updated on November 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.