KELLY RENEE MEBRUER
NPI 1144189788
Physician Assistant - Surgical in Saint Louis, MO

Q: What is Kelly Mebruer's NPI number?

The NPI number for Kelly Mebruer is 1144189788. It was assigned to this individual provider in the NPPES registry on January 20, 2026.

Q: What is Kelly Mebruer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Mebruer was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since January 20, 2026PECOS Enrolled

1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 577-5600 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 10, 2026, Jan 20, 2026 (2 updates tracked since 2026).

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About Kelly Renee Mebruer NPPES

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

KELLY RENEE MEBRUER (NPI 1144189788) is an individual surgical provider in Saint Louis, Missouri and active in the NPI registry since January 2026. She is enrolled in Medicare PECOS and is a graduate of Saint Louis University School Of Medicine (2025).

NPPES Registry Identity

NPI1144189788

Entity TypeIndividualFemale

Primary Taxonomy363AS0400X

Provider Legal NameKELLY RENEE MEBRUER

Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003

Mailing Address1465 S Grand BlvdSaint Louis, MO 63104-1003

Phone(314) 577-5600

Sole ProprietorNo

Medical School CMSSaint Louis University School Of MedicineGraduated 2025

Enumeration DateJanuary 20, 2026

Last NPPES UpdateMarch 10, 20262 updates tracked since enumeration

NPPES CertifiedMarch 10, 2026

✔ NPI 1144189788 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician Assistant · SurgicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AS0400X

Also ListedPhysician AssistantTaxonomy 363A00000X · License 2026005849 (MO)

1465 S GRAND BLVD, Saint Louis, MO 63104

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Renee Mebruer is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8921573429

PECOS Enrollment IDI20260413002078

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.

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. SARAH MARGARET HANLY PH.D.

Psychologist (Clinical)

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 577-5667

KAVIPRIYA KOMESWARAN

Pediatrics (Pediatric Critical Care Medicine)

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 617-2000

ALEXIS HAAS STEWART

Anesthesiologist Assistant

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 977-5700

NATALIE DRURY RD, LD

Dietitian, Registered (Nutrition, Pediatric)

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 577-5387

TIMOTHY J KUTZ MD

Pediatrics (Child Abuse Pediatrics)

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 268-6406

CHRISTOPHER SALLEE MD

Pediatrics

1465 S GRAND BLVD
ST. LOUIS, MO 63104

St. Louis City (314) 577-1607

AMBER GRANA DO

Pediatrics (Pediatric Critical Care Medicine)

1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104

St. Louis City (314) 577-5695

DR. ETHAN EMIL PFEIFER MD

Student in an Organized Health Care Education/Training Program

1465 S GRAND BLVD
SAINT LOUIS, MO 63104

St. Louis City (314) 268-4070

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 Kelly Mebruer's NPI number?

The NPI number for Kelly Mebruer is 1144189788. It was assigned to this individual provider in the NPPES registry on January 20, 2026.

Where is Kelly Mebruer located?

Kelly Mebruer practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 577-5600.

What is Kelly Mebruer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.

Is Kelly Mebruer enrolled in Medicare?

Yes. Kelly Mebruer is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Mebruer was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.