Justin Ross Ellingworth, CAA
NPI 1780243451ActiveIndividual· Anesthesiologist Assistant· Saint Louis, MO
Anesthesiologist Assistant (CAA) with Ssm Health Care Group, practicing in Saint Louis, Missouri. Enrolled in Medicare as practitioner - anesthesiology assistant and practitioner - anesthesiology assistant. Lists Ssm Health St Mary's Hospital - St Louis as a hospital affiliation.
Overview
| NPI | 1780243451 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CAA |
| Sole proprietor | No |
| NPI issued | Jun 6, 2019 |
| Last updated in NPPES | Jul 8, 2025 |
| Certified by provider | Jul 8, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiologist Assistant Primary | 367H00000X | 2025024808 | MO |
| Anesthesiologist Assistant | 367H00000X | 75000041A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Anesthesiology Assistant (IN); Practitioner - Anesthesiology Assistant (MO) |
|---|
Education and affiliations
| Graduation year | 2019 |
|---|---|
| Medicare specialty | Anesthesiology Assistant |
Medical group
- Ssm Health Care GroupSaint Louis, MO · 940 clinicians
Hospital affiliation
- Ssm Health St Mary's Hospital - St LouisSaint Louis, MO
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