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

Justin Ross Ellingworth, CAA

Individual provider Anesthesiologist Assistant · NPI 1780243451

Justin Ross Ellingworth, CAA is an Anesthesiology Assistant in Saint Louis, Missouri. Qualified in 2019, 7 years ago. Practices with SSM Health Care Group, a 923-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana and Missouri.

Years since qualifying
7
Licensed in
IN, MO
In the registry since
2019
Specialties on file
2
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Practice location Address checks out

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 617-2000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 705 Riley Hospital Dr, Indianapolis, IN 46202-5109 — (317) 944-9981

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X · Licence 2025024808 (MO)
Anesthesiologist Assistant Taxonomy 367H00000X · Licence 75000041A (IN)

Record details

NPI number1780243451
Entity typeIndividual (Type 1)
GenderMale
Credentials CAA
Sole proprietorNo
NPI enumeratedJune 6, 2019
Last updated in NPPESJuly 8, 2025
Certification dateJuly 8, 2025

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Ssm Health Care Group — 923 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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