Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Connor Passalacqua

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1598408262

Connor Passalacqua is a Family Practice in Boardman, Ohio. Qualified in 2022, 4 years ago. Works from 3 locations. Licensed in Indiana and Ohio.

Years since qualifying
4
Licensed in
IN, OH
In the registry since
2022
Specialties on file
4
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Practice location Address checks out

8423 Market St Ste 207
Boardman, OH 44512-6778
Phone: (330) 729-8700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 313 Federal Dr Nw Ste 200, Corydon, IN 47112-3079 — (812) 738-4155
  • 966 Bartley St, Jasper, IN 47546-2641 — (812) 996-7810

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01099775A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (OH)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (IN)

Record details

NPI number1598408262
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 19, 2022
Last updated in NPPESJune 4, 2026
Certification dateJune 4, 2026
Mailing address966 Bartley St, Jasper, IN 47546-2641

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Boardman