MATTHEW A PASSALACQUA, DO CLEVELAND, OH

Contact Information

MATTHEW A PASSALACQUA, DO

11100 EUCLID AVENUE
CLEVELAND, OH 44106

Phone: 216-844-1700
Fax:
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Vascular & Interventional Radiology	2085R0204X	94	Physician/Interventional Radiology
Body Imaging	2085B0100X
Diagnostic Neuroimaging	2085D0003X
Diagnostic Radiology	2085R0202X	30	Physician/Diagnostic Radiology
Diagnostic Ultrasound	2085U0001X
Hospice and Palliative Medicine	2085H0002X
In Vivo & In Vitro Nuclear Medicine	207UN0903X	36	Physician/Nuclear Medicine
Neuroradiology	2085N0700X
Nuclear Cardiology	207UN0901X	36	Physician/Nuclear Medicine
Nuclear Imaging & Therapy	207UN0902X	36	Physician/Nuclear Medicine
Nuclear Medicine	207U00000X	36	Physician/Nuclear Medicine
Nuclear Radiology	2085N0904X
Pediatric Radiology	2085P0229X
Radiation Oncology	2085R0001X	92	Physician/Radiation Oncology
Radiation Oncology	2085R0203X

Indicates primary specialty

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NPI Profile & details for MATTHEW A PASSALACQUA · (Male)

NPI #	`1639152457`
Status	Active
Credentials	DO (Doctor of Osteopathic)
Entity	Individual
Enumeration date	11/25/2005
Last updated	10/30/2013 - About 13 years ago
Sole proprietor ¹	No
Identifiers	OH License # 34005244 OH License # 34005244P OH Medicaid 0924398 OH Other 5261551 AETNA OH Other 000000550367 ANTHEM OH Other 000000364066 ANTHEM ID OH Other 0304914 BCMH OH Other 733909 BUCKEYE OH Other P00224514 RAILROAD MEDICARE OH Other P00454367 RAILROAD MEDICARE OH Other 421816 WELLCARE
Hospital affiliation(s)	LAKE HEALTH - (Acute Care) 7590 AUBURN ROAD CONCORD, OH 44077

¹ A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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MATTHEW A PASSALACQUA, DO – NPI #1639152457Vascular & Interventional Radiology

Contact Information

Specialty

NPI Profile & details for MATTHEW A PASSALACQUA · (Male)

Reviews for MATTHEW A PASSALACQUA

MATTHEW A PASSALACQUA, DO – NPI #1639152457
Vascular & Interventional Radiology