JONATHAN D MAYBERRY AGACNP-BC
NPI 1679330419
Nurse Practitioner - Critical Care Medicine in Saint Louis, MO
About Jonathan D Mayberry Agacnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JONATHAN D MAYBERRY AGACNP-BC (NPI 1679330419) is an individual critical care medicine provider in Saint Louis, Missouri, licensed in Missouri (2015020871) and active in the NPI registry since February 2024. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Jonathan D Mayberry Agacnp-bc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Jonathan Mayberry reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Saint Louis, MO 63141
- Reassigned Medicare billing, Missouri enrollment
- 77 clinicians in this Medicare group
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 63141 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
SAINT LOUIS, MO 63141
SAINT LOUIS, MO 63141
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 Jonathan Mayberry's NPI number?
The NPI number for Jonathan Mayberry is 1679330419. It was assigned to this individual provider in the NPPES registry on February 28, 2024.
Where is Jonathan Mayberry located?
Jonathan Mayberry practices at 615 S New Ballas Rd, Saint Louis, MO 63141. The listed phone number is (314) 251-6000.
What is Jonathan Mayberry's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Critical Care Medicine, with taxonomy code 363LC0200X.
Is Jonathan Mayberry enrolled in Medicare?
Yes. Jonathan Mayberry is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Jonathan Mayberry's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jonathan Mayberry reassigns Medicare benefits to Mercy Clinic Adult Critical Care, LLC (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 Jonathan Mayberry's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Jonathan Mayberry was last updated on February 28, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Jonathan D Mayberry, AGACNP-BC · NPI 1679330419
Critical Care Medicine physician in Saint Louis, Missouri. Individual provider, active in the CMS NPPES registry since February 28, 2024.
## Identity
- **NPI:** 1679330419 (Entity type: Individual)
- **Enumerated:** February 28, 2024
- **Primary specialty:** Nurse Practitioner - Critical Care Medicine · taxonomy 363LC0200X
- **State license:** 2015020871 (Missouri)
- **Sole proprietor:** No
## Practice location
- **Address:** 615 S NEW BALLAS RD, Saint Louis, MO 63141-8221
- **Phone:** (314) 251-6000
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Mercy Clinic Adult Critical Care, LLC (NPI 1730119421, Saint Louis, MO), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 28, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1679330419) · Data from the CMS NPPES public registry.