Connor George Passalacqua, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

130 Lomond CT Ste 1
Utica, NY 13502-5951

Phone

(315) 724-4286

NPI assigned

Aug 17, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1597622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1992316525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8720 AITKEN AVE",
            "city": "WHITESBORO",
            "state": "NY",
            "postal_code": "134922606",
            "telephone_number": "315-507-0762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 LOMOND CT STE 1",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025951",
            "telephone_number": "315-724-4286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASSALACQUA",
        "first_name": "CONNOR",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-17",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgpassal@utica.edu",
            "affiliation": "N",
            "address_1": "130 Lomond Ct Ste 1",
            "city": "Utica",
            "state": "NY",
            "country_code": "US",
            "postal_code": "135025951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Utica, NY
• Providers in Utica, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.