Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kennedy Marie Isaak, PA

Individual provider Physician Assistant · NPI 1871254615

Kennedy Marie Isaak, PA is a Physician Assistant in Saint Louis, Missouri. Qualified in 2022, 4 years ago. Practices with Mercy Clinic Childrens Surgery LLC, a 3-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
4
Licensed in
MO
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

621 S New Ballas Rd Ste 63B
Saint Louis, MO 63141-8251
Phone: (314) 960-8771
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12700 Southfork Rd Ste 100, Saint Louis, MO 63128-3201 — (314) 251-3500

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2023014817 (MO)

Record details

NPI number1871254615
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJanuary 4, 2022
Last updated in NPPESApril 1, 2024
Certification dateApril 1, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Mercy Clinic Childrens Surgery Llc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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