Justin Ellingworth, CAA
NPI 1780243451 · Anesthesiologist Assistant · Saint Louis, MO
Enrolled with Medicare as Practitioner - Anesthesiology Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1780243451
- Entity type
- Individual
- Primary specialty
- Anesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CAA
- Sex
- Male
- Sole proprietor
- No
- License
- 75000041A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 705 Riley Hospital DrIndianapolis, IN 46202-5109Phone: (317) 944-9981Fax: (317) 944-0282
Registry dates
- Enumerated
- 2019-06-06
- Last updated
- 2025-07-08
- Certified
- 2025-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.