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

Elena Kozaryuk

Individual provider Adult Health Nurse Practitioner · NPI 1255088191

Elena Kozaryuk is a Nurse Practitioner in Saint Louis, Missouri. Qualified in 2019, 7 years ago. Practices with SSM Medical Group Inc, a 560-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
7
Licensed in
MO
In the registry since
2022
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Practice location Address checks out

11716 Studt Ave
Saint Louis, MO 63141-7018
Phone: (314) 330-8117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 2020037156 (MO)

Record details

NPI number1255088191
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedMarch 9, 2022
Last updated in NPPESMarch 9, 2022
Certification dateMarch 9, 2022

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ssm Medical Group Inc — 560 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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