NPIMap

Individual provider Active NPI

Susan Passalaqua, M.D.

  • Diagnostic Radiology Physician
  • Gilbert, AZ
National Provider Identifier
1891784880
Registry record updated Jan 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
32391 Issued in AZ
Practice address
2946 E Banner Gateway Dr.
Gilbert, AZ 85234
Phone
(480) 256-6444
Fax
(480) 256-4683
NPI assigned
Oct 21, 2005
Last updated
Jan 21, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 32391 AZ Primary

Addresses

Primary practice location

2946 E Banner Gateway Dr.
Gilbert, AZ 85234

Mailing address

2940 E Banner Gateway Dr. Ste 450
Gilbert, AZ 85234
Phone (480) 425-5063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, SD, MN3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20040701001142 AZ Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 3375520919 Reassigns benefits to 1 organization
I20230113002420 SD Practitioner - Diagnostic Radiology 3375520919 Reassigns benefits to 6 organizations
I20260112001910 MN Practitioner - Diagnostic Radiology 3375520919 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical College of Ohio, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians
Avera McKennanGroup PAC ID 0345157103, 957 clinicians
Avera MarshallGroup PAC ID 5799695227, 102 clinicians
Avera Queen of PeaceGroup PAC ID 9335050806, 122 clinicians
Urology Specialists CharteredGroup PAC ID 9234031329, 47 clinicians
City of Hope Medical Group of Arizona LLCGroup PAC ID 2264593474, 159 clinicians
Madison Community HospitalGroup PAC ID 3779579743, 46 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

201 W 69TH St
Sioux Falls, SD 57108-2403
Phone (605) 336-0635

20159 N Scottsdale Rd
Suite 100
Scottsdale, AZ 85255-6808
Phone (623) 265-7215

323 SW 10TH St
Madison, SD 57042-3200
Phone (605) 256-6551

525 N Foster St
Mitchell, SD 57301-2966
Phone (605) 995-2234

649 /2 State St NW
Evansville, MN 56326-8124
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537-2913
Phone (218) 736-8000

901 E Virgil Ave
Milbank, SD 57252-2124
Phone (605) 432-4538

910 E 20TH St
Sioux Falls, SD 57105-1012
Phone (605) 334-6730

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan Diagnostic Radiology CurrentSince Jan 1, 2023 Accepting new patients
Avera Queen of Peace Current Accepting new patients
Avera Queen of Peace CurrentSince Jan 1, 2023 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Dec 15, 2025 Accepting new patients
Avera Marshall CurrentSince Jan 1, 2023 Accepting new patients
Avera McKennan CurrentSince Jan 1, 2023 Accepting new patients
Madison Community Hospital CurrentSince Jan 1, 2023 Accepting new patients
Avera McKennan Current Accepting new patients
Avera Queen of Peace CurrentSince Jan 1, 2023 Accepting new patients
Urology Specialists Chartered CurrentSince Jan 1, 2023 Accepting new patients
Lake Region Healthcare Corporation CurrentSince Dec 15, 2025 Accepting new patients
Madison Community Hospital CurrentSince Jan 1, 2023 Accepting new patients
Avera Marshall CurrentSince Jan 1, 2023 Accepting new patients
Banner Imaging Associates PLC Diagnostic Radiology Past Accepting new patients
Tyler Healthcare Center Dba Tyler Healthcare Pharmacy Past Accepting new patients
Avera McKennan Past Accepting new patients
Medical Doctors Imaging Inc a Medical Group Diagnostic Radiology Past Accepting new patients
Scottsdale Medical Imaging, LTD Diagnostic Radiology Past Accepting new patients
City of Hope Medical Group of Arizona LLC Diagnostic Radiology Past Accepting new patients
Regional Radiological Associates, Inc. a Medical Group Diagnostic Radiology Past Accepting new patients
Granite Falls Municipal Hospital and Manor Past Accepting new patients
Southwest Diagnostic Imaging LLC Diagnostic Radiology PastSince Apr 20, 2021 Accepting new patients

Locations

1411 Highway 79 E
Elbow Lake, MN 56531
Phone (218) 685-7300

649 State St NW
Evansville, MN 56326
Phone (218) 948-2040

712 S Cascade St
Fergus Falls, MN 56537

300 S Bruce St
Marshall, MN 56258
Phone (507) 532-9631

323 SW 10th St
Madison, SD 57042
Phone (605) 256-6551

525 N Foster St
Mitchell, SD 57301
Phone (605) 995-2000

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

201 W 69th St
Sioux Falls, SD 57108
Phone (605) 336-0635

910 E 20th St
Sioux Falls, SD 57105
Phone (602) 338-7098

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: susan.passalaqua.p1@direct.urologyspecialists.nextgenshare.com

Organizations & group practices 24

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 24

Hospital & facility affiliations 29

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 29

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421798400000",
    "number": "1891784880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2940 E BANNER GATEWAY DR. STE 450",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-425-5063",
            "fax_number": "480-425-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2946 E BANNER GATEWAY DR.",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "85234",
            "telephone_number": "480-256-6444",
            "fax_number": "480-256-4683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSALAQUA",
        "first_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-21",
        "last_updated": "2015-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "32391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

Verify at the official NPI Registry.