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JUSTIN ROSS ELLINGWORTH CAA
NPI 1780243451
Anesthesiologist Assistant in Saint Louis, MO

Active since June 06, 2019Accepts Medicare Assignment
1465 S GRAND BLVD, SAINT LOUIS, MO 63104(314) 617-2000 Get Directions Write a Review

NPPES record last updated: July 8, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 8, 2025, Jun 6, 2019 (2 updates tracked since 2019).

About Justin Ross Ellingworth Caa NPPES

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

JUSTIN ROSS ELLINGWORTH CAA (NPI 1780243451) is an individual anesthesiologist assistant in Saint Louis, Missouri, licensed in Missouri (2025024808) and active in the NPI registry since June 2019. He maintains a secondary practice location in Indianapolis and is a graduate of Other (2019).

NPPES Registry Identity

NPI1780243451
Entity TypeIndividualMale
Primary Taxonomy367H00000X
Provider Legal NameJUSTIN ROSS ELLINGWORTHCredential: CAA
Location Address1465 S GRAND BLVDSaint Louis, MO 63104-1003
Mailing Address950 N Meridian St Ste 500Indianapolis, IN 46204-3908 · Fax (317) 962-4950
Phone(314) 617-2000
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateJune 6, 2019
Last NPPES UpdateJuly 8, 20252 updates tracked since enumeration
NPPES CertifiedJuly 8, 2025
✔ NPI 1780243451 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367H00000X
Licenses✔ Licensed in MO · 2025024808✔ Licensed in IN · 75000041A
Definition
An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.
1465 S GRAND BLVD, Saint Louis, MO 63104
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Secondary Practice Location 1

Location 1705 Riley Hospital DrIndianapolis, IN 46202-5109 · Phone (317) 944-9981 · Fax (317) 944-0282

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Justin Ross Ellingworth Caa is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517291008
PECOS Enrollment IDI20250714002469

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. SARAH MARGARET HANLY PH.D.
Psychologist (Clinical)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5667
KAVIPRIYA KOMESWARAN
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 617-2000
ALEXIS HAAS STEWART
Anesthesiologist Assistant
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 977-5700
NATALIE DRURY RD, LD
Dietitian, Registered (Nutrition, Pediatric)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5387
TIMOTHY J KUTZ MD
Pediatrics (Child Abuse Pediatrics)
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-6406
CHRISTOPHER SALLEE MD
Pediatrics
1465 S GRAND BLVD
ST. LOUIS, MO 63104
St. Louis City (314) 577-1607
AMBER GRANA DO
Pediatrics (Pediatric Critical Care Medicine)
1465 S GRAND BLVD, DIVISION OF PEDIATRIC CRITICAL CARE
SAINT LOUIS, MO 63104
St. Louis City (314) 577-5695
DR. ETHAN EMIL PFEIFER MD
Student in an Organized Health Care Education/Training Program
1465 S GRAND BLVD
SAINT LOUIS, MO 63104
St. Louis City (314) 268-4070

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 Justin Ellingworth's NPI number?

The NPI number for Justin Ellingworth is 1780243451. It was assigned to this individual provider in the NPPES registry on June 6, 2019.

Where is Justin Ellingworth located?

Justin Ellingworth practices at 1465 S Grand Blvd, Saint Louis, MO 63104. The listed phone number is (314) 617-2000.

What is Justin Ellingworth's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Is Justin Ellingworth enrolled in Medicare?

Yes. Justin Ellingworth is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Justin Ellingworth accept?

Health plans from CareSource list Justin Ellingworth 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 Justin Ellingworth was last updated on July 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.