Active NPI
Walter J Passarello, DO
- Family Medicine Physician
- Poland, OH
National Provider Identifier
1376536847
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 34006450
- Practice address
- 6615 Clingan Rd
Suite C
Poland, OH 44514-2159 - Phone
- (330) 757-7888
- Fax
- (330) 757-4912
- NPI assigned
- Aug 30, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34006450 | OH | Primary |
Addresses
Primary practice location
6615 Clingan Rd
Suite C
Poland, OH 44514-2159
Mailing address
6615 Clingan Rd
Suite C
Poland, OH 44514-2159
Phone (330) 757-7888
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000507817 | Other | ANTHEM | |
| 2101120 | Medicaid | OH | |
| 000000139454 | Other | OH | ANTHEM BC/BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OH
- 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 |
|---|---|---|---|---|
| I20061205000136 | OH | Practitioner - Family Practice | 0941209829 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio University, College of Osteopathic Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6615 Clingan Rd
C
Poland, OH 44514-2135
Phone (330) 757-7888
Hospital & facility affiliations
- Akeso Home Health Care Inc
- Patriot Homecare, Inc
- HMHP St Elizabeth Boardman Health Center
- MH St Elizabeth Youngstown Hospital
- Surgical Hospital at Southwoods
- Meadville Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.47 of 100
- Quality
- 73.84
- Improvement activities
- 40
- Cost
- 76.44
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Melanoma (skin cancer) excision | 1-10 |
| Removal of skin lesions | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34006450 | OH | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poland Medical Center LTD | Family Medicine | Current | Accepting new patients |
| Walter J Passarello, DO LLC | Past | Accepting new patients | |
| Health Care Providers Inc | Family Medicine | Past | Accepting new patients |
| Pathology Laboratories, Inc. | Past | Accepting new patients |
Locations
6615 Clingan Rd
Ste A
Youngstown, OH 44514
Phone (330) 707-1425
6615 Clingan Rd
Ste C
Youngstown, OH 44514
Phone (330) 757-7888
Interoperability endpoints
- wpassarello@polandmedical.medentdirect.com
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Physician
- Boardman, OH
- NPI 1669687760
-
- Clinical Medical Laboratory
- Toledo, OH
- NPI 1346285988
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Canfield, OH
- NPI 1821357617
-
- Home Health Agency
- Girard, OH
- NPI 1598061418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409011200000",
"number": "1376536847",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6615 CLINGAN RD",
"address_2": "SUITE C",
"city": "POLAND",
"state": "OH",
"postal_code": "445142159",
"telephone_number": "330-757-7888",
"fax_number": "330-757-4912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6615 CLINGAN RD",
"address_2": "SUITE C",
"city": "POLAND",
"state": "OH",
"postal_code": "445142159",
"telephone_number": "330-757-7888",
"fax_number": "330-757-4912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PASSARELLO",
"first_name": "WALTER",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2014-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OH",
"license": "34006450",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "000000507817",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2101120",
"state": "OH"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "000000139454",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Poland, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.