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ST LOUIS KIDNEY, LLC
NPI 1730593757
Internal Medicine - Nephrology in Creve Coeur, MO

Active since June 18, 2014CLIA 26D2199674 · Microscopy
456 N NEW BALLAS RD STE 348, CREVE COEUR, MO 63141(314) 548-0265(314) 548-6555 Get Directions Write a Review

NPPES record last updated: September 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 11, 2020, Aug 11, 2020, Sep 10, 2019 (3 updates tracked since 2019).

About St Louis Kidney, Llc NPPES

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

ST LOUIS KIDNEY, LLC (NPI 1730593757) is a healthcare organization registered as a nephrology in Creve Coeur, Missouri and active in the NPI registry since June 2014. The organization holds a CLIA Microscopy certificate valid through November 9, 2026 and lists Derek Sloan Larson, Owner, as its authorized official.

NPPES Registry Identity

NPI1730593757
Entity TypeOrganization
Primary Taxonomy207RN0300X
Legal Business NameST LOUIS KIDNEY, LLC
Location Address456 N NEW BALLAS RD STE 348Creve Coeur, MO 63141-6846
Mailing AddressPo Box 78429Saint Louis, MO 63178-8429 · (314) 548-0265 · Fax (314) 548-6555
Phone(314) 548-0265
Fax(314) 548-6555
Organization SubpartNo
Authorized OfficialDerek Sloan LarsonOwner · (314) 548-0265
Enumeration DateJune 18, 2014
Last NPPES UpdateSeptember 30, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 30, 2025
✔ NPI 1730593757 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code207RN0300X
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
456 N NEW BALLAS RD STE 348, Creve Coeur, MO 63141
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Other Identifiers 1

Medicaid500014637MO

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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 and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St Louis Kidney, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

6

Medicare enrollment records show 6 clinicians reassign Medicare billing to St Louis Kidney, LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address. They are listed nearest first.

Clinicians, nearest first (6)

Nathaniel Reisinger, MD
Nephrology
NPI 1881960938
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address
Candace Shirley, NP-C
Nurse Practitioner
NPI 1891242921
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address
Rohan Devanpalli- Ramaya, M.D
Internal Medicine
NPI 1396057535
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address
Derek Larson, M.D.
Internal Medicine
NPI 1588820096
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address
Graeme Mindel, M.D.
Nephrology
NPI 1932196854
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address
Jay Seltzer, MD
Nephrology
NPI 1568433902
456 N NEW BALLAS RD STE 348
Creve Coeur, MO 63141
(314) 548-0265
✔ PECOS✔ Accepts MedicareSame address

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 26D2199674

St Louis Kidney Consultants · Saint Louis, MO
Active · expires Nov 9, 2026
CLIA Number26D2199674
Laboratory TypePhysician Office
Certificate Effective DateNovember 10, 2024
Certificate Expiration DateNovember 9, 2026
Laboratory DirectorJay R. Seltzer
Laboratory Phone(314) 548-0265
Laboratory LocationSt Louis Kidney Consultants456 N New Ballas Rd - Ste 348, Saint Louis, MO 63141
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

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 St Louis Kidney, LLC's NPI number?

The NPI number for St Louis Kidney, LLC is 1730593757. It was assigned to this organization in the NPPES registry on June 18, 2014.

Where is St Louis Kidney, LLC located?

St Louis Kidney, LLC is located at 456 N New Ballas Rd Ste 348, Creve Coeur, MO 63141. The listed phone number is (314) 548-0265.

What is St Louis Kidney, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is St Louis Kidney, LLC enrolled in Medicare?

Yes. St Louis Kidney, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through St Louis Kidney, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 3 Medicare specialties reassign their Medicare billing to St Louis Kidney, LLC. A 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 the clinician's services. The largest specialties are Nephrology (3), Internal Medicine (2) and Nurse Practitioner (1). Of these, 6 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does St Louis Kidney, LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 26D2199674) is associated with this NPI, valid through November 9, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does St Louis Kidney, LLC 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 3 other insurers list St Louis Kidney, LLC 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 St Louis Kidney, LLC was last updated on September 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.