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

Tyler Stephanie Passalacqua, PA-C

Individual provider Medical Physician Assistant · NPI 1225659147

Tyler Stephanie Passalacqua, PA-C is a Physician Assistant in Boca Raton, Florida. Graduated from Florida International Univ, College of Medicine in 2019, 7 years ago. Practices with Complete Local Specialty Care Inc, a 29-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
7
Trained at
Florida International Univ, College of Medicine
Licensed in
FL
In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

950 Glades Rd Ste 4A
Boca Raton, FL 33431-6401
Phone: (561) 391-8086
Fax: (954) 418-1698
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PA9113012 (FL)

Record details

NPI number1225659147
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMay 1, 2020
Last updated in NPPESFebruary 4, 2022
Certification dateFebruary 4, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolFLORIDA INTERNATIONAL UNIV, COLLEGE OF MEDICINE
Graduated 2019 (7 years in practice)
Group practice Complete Local Specialty Care Inc — 29 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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