LISA LYNN PASSALACQUA PA-C
NPI 1275140550
Physician Assistant - Medical in Santa Ana, CA

Q: What is Lisa Passalacqua's NPI number?

The NPI number for Lisa Passalacqua is 1275140550. It was assigned to this individual provider in the NPPES registry on September 30, 2020.

Q: What is Lisa Passalacqua's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Passalacqua was last updated on September 25, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since September 30, 2020PECOS Enrolled

210 N TUSTIN AVE, SANTA ANA, CA 92705(888) 959-5192 Get Directions Write a Review

NPPES record last updated: September 25, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Lisa Lynn Passalacqua Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LISA LYNN PASSALACQUA PA-C (NPI 1275140550) is an individual medical provider in Santa Ana, California, licensed in California (58543) and active in the NPI registry since September 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1275140550

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameLISA LYNN PASSALACQUACredential: PA-C

Location Address210 N TUSTIN AVESanta Ana, CA 92705-3807

Mailing Address210 N Tustin AveSanta Ana, CA 92705-3807 · (888) 959-5192

Phone(888) 959-5192

Sole ProprietorNo

Enumeration DateSeptember 30, 2020

Last NPPES UpdateSeptember 25, 2023

NPPES CertifiedSeptember 25, 2023

✔ NPI 1275140550 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in CA · 58543

210 N TUSTIN AVE, Santa Ana, CA 92705

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Lynn Passalacqua Pa-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SAN DIEGUITO ANESTHESIOLOGY MEDICAL GROUP, INC.

Anesthesiology