Active NPI
Sydney Elizondo, MD
- Neurology with Special Qualifications in Child Neurology Physician
- Saint Louis, MO
National Provider Identifier
1609562511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 2025026034
- Practice address
- 1201 S Grand Blvd
Saint Louis, MO 63104-1016 - Phone
- (314) 257-8000
- NPI assigned
- Apr 13, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 2025026034 | MO | Primary |
Addresses
Primary practice location
1201 S Grand Blvd
Saint Louis, MO 63104-1016
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (636) 222-8619
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250818002431 | MO | Order and Referring Only - Neurology | 5890294763 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2025026034 | MO | MD | Neurology with Special Qualifications in Child Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681344000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757635200000",
"number": "1609562511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1465 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041003",
"telephone_number": "636-222-8619"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1201 S GRAND BLVD",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631041016",
"telephone_number": "314-257-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ELIZONDO",
"first_name": "SYDNEY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-13",
"last_updated": "2025-09-12",
"certification_date": "2025-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MO",
"license": "2025026034",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.