ZACHARY KISLEY (DO) – Nephrology Physician, NPI 1629606298

ZACHARY KISLEY (DO) is a healthcare provider. based in Saint louis, Missouri. specializing in NEPHROLOGY. They hold the professional credentials DO. They hold a License No. 2025035191 (MO). The NPI Number for ZACHARY KISLEY (DO) is 1629606298

Main info

Male
6 Years Of Experience
Accepts Medicare Assignment
Name
ZACHARY KISLEY (DO)
NPI
1629606298
Phone
(314) 577-8762
Address
1402 S GRAND BLVD
Enumeration Date
30 March 2020
Last Update Date
24 August 2025

Doctor Profile

Medical School Name
MIDWESTERN UNIVERSITY, CHICAGO COLLEGE OF OSTEOPATHIC MED
Secondary Phone
3148429669
Graduation Year
2020 (6 years ago)
PAC ID
0446674394
Group Practice PAC ID
1658797246
Professional Enrollment ID
I20250829002478
Address ID
MO631183905SA3740XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience41
Completeness85
Years active:6State licenses:1Digital endpointsOther names

319 NEPHROLOGY in MO

Provider Addresses for ZACHARY KISLEY (DO)

  • 1402 S GRAND BLVD

    SAINT LOUIS, MO 631041004

    Phone: (314) 577-8762

    Fax: (314) 268-5108

    Type: Mailing

  • 3660 VISTA AVE

    SAINT LOUIS, MO 631102540

    Phone: (314) 977-6100

    Fax: (314) 977-6164

    Type: Location

  • PO BOX 802841

    KANSAS CITY, MO 641802841

    Phone: (314) 842-9669

    Fax: (314) 842-1017

    Type: Mailing

  • 10004 KENNERLY RD STE 374B

    SAINT LOUIS, MO 631282178

    Phone: (314) 842-9669

    Fax: (314) 842-1017

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-08-29

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250829002478INephrologyMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 63104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658797246View full group profile
NameSpecialtyState
Internal Medicine, NephrologyIL
Nurse PractitionerMO
N E P H R O L O G YMO
Nurse PractitionerMO
Emergency Medicine, Internal MedicineMO
Nurse PractitionerMO
N E P H R O L O G YMO

Reviews

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Frequently asked questions

What number should I use to identify ZACHARY KISLEY (DO) for billing?
Administrative and clinical systems typically use NPI 1629606298 for ZACHARY KISLEY (DO).
Should I treat ZACHARY KISLEY (DO) as an active provider?
Patients and plans typically see ZACHARY KISLEY (DO) as active in the national extract.
What type of care does ZACHARY KISLEY (DO) provide?
ZACHARY KISLEY (DO)'s profile centers on Nephrology Physician. Clinical services aligned with this taxonomy classification.
Can patients visit ZACHARY KISLEY (DO) in Saint Louis, Missouri?
For routing, start with Saint Louis, Missouri for ZACHARY KISLEY (DO), then verify phone and hours locally.
Who maintains ZACHARY KISLEY (DO)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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