MR. LUKAS MICHEAL PASSALACQUA (NPI# 1104314046) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104314046 |
| Entity Type | Individual |
| Full Name | MR. LUKAS MICHEAL PASSALACQUA |
| Credential | MSAT, ATC |
| Practice Address |
900 N John R Wooden Dr West Lafayette IN 47907 |
| Mailing Address |
900 N John R Wooden Dr West Lafayette IN 47907-2117 |
| Practice Telephone | 7654943245 |
| Practice Fax Number | 7654949899 |
| Mailing Telephone | 7654943245 |
| Enumeration Date | 2018-04-26 |
| Last Update Date | 2019-11-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
36003098A | IN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
1631 | AZ | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 900 N John R Wooden Dr, West Lafayette, IN 47907 | 7654943245 | 7654949899 |
| Street Address |
900 N JOHN R WOODEN DR |
| City | WEST LAFAYETTE |
| State | IN |
| Zip Code | 47907 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770570616 | Gregory A Rowdon | Internal Medicine | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2005-10-05 |
| 1699373837 | Hope Elizabeth Walker | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-10 |
| 1245837699 | Mckayla Deborah Tallman | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-07 |
| 1295332054 | Samari Jo Thomas | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-10-05 |
| 1184231417 | Samantha Betty Lee Archer I | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-30 |
| 1417564717 | Isabella Hannigan | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-30 |
| 1700493483 | Blaine Michael Kidd | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-28 |
| 1780291419 | Madison Taylor Stewart | Student in an Organized Health Care Education/Training Program | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-27 |
| 1861007718 | Alexis Lillian Branham | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-08 |
| 1568076958 | Abigail Marie Stoy | Specialist/Technologist | 900 N John R Wooden Dr, West Lafayette, IN 47907-2117 | 2020-09-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285274464 | Christine Michelle Jones | Nurse Practitioner | Lyles-porter Hall 715 Clinic Drive, West Lafayette, IN 47907 | 2020-01-15 |
| 1013415033 | Brianna Johnson | Psychologist | 601 Stadium Mall Drive, Purdue University Student Health Center, 2nd Floor, West Lafayette, IN 47907 | 2018-01-24 |
| 1285095885 | Christina Ellen Manfred | Nurse Practitioner | 601 W. Stadium Ave, West Lafayette, IN 47907 | 2016-03-10 |
| 1265612626 | Anu Subramanian | Speech-Language Pathologist | 500 Oval Drive Purdue University, Dept of Speech Language and Hearing Sciences, West Lafayette, IN 47907 | 2007-11-13 |
| 1720163348 | Andrea Lynn Lopez | Specialist/Technologist | 900 N. University Ave, Room B63, West Lafayette, IN 47907 | 2006-10-25 |
| 1912914680 | Jeanette Stone Leonard | Audiologist | 715 Clinic Drive, Purdue University, West Lafayette, IN 47907 | 2006-08-02 |
| 1447224977 | Lindsey Ann Watson | Specialist/Technologist | 900 N University Dr, Mackey Arena, Room B60, West Lafayette, IN 47907 | 2006-02-13 |
| 1992280960 | Carol Callahan Lancaster | Nurse Practitioner | 601 Stadium Mall Drive, West Lafayette, IN 47907 | 2018-09-26 |
| 1053712570 | Purdue Sports Medicine Wl | Internal Medicine | 900 John R Wooden Drive, Mackey Arena, West Lafayette, IN 47907 | 2014-09-16 |
| 1437401130 | Jennifer K Popp | Specialist/Technologist | 800 W Stadium Ave, West Lafayette, IN 47907 | 2012-10-05 |
| Find all providers in zip 47907 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538703921 | Meghan Nicole Jacobs | Specialist/Technologist | 610 Purdue Mall, West Lafayette, IN 47907-2040 | 2019-10-29 |
| 1720563729 | Abbey Colclasure | Specialist/Technologist | 2101 Cumberland Ave Apt 11207, West Lafayette, IN 47906-4076 | 2018-09-26 |
| 1861977712 | Ryan Joseph Salerno | Specialist/Technologist | 900 N John R Wooden Dr Rm B198, West Lafayette, IN 47907-2117 | 2018-09-26 |
| 1992290530 | Cameron Eldred | Specialist/Technologist | 3367 Edison Dr, West Lafayette, IN 47906 | 2018-06-26 |
| 1720593403 | Devin Kay Hall | Specialist/Technologist | 900 John R. Wooden Drive, West Lafayette, IN 47906 | 2017-12-04 |
| 1396262499 | Travis Michael Miller | Specialist/Technologist | Wiley Hall Rm 183, West Lafayette, IN 47906-4225 | 2017-08-29 |
| 1609398270 | Christian Floirendo | Specialist/Technologist | 2225 Willowbrook Dr, #207, West Lafayette, IN 47906 | 2017-07-14 |
| 1649631383 | Jordan Leikel | Specialist/Technologist | 2803 Grayleaf Dr, West Lafayette, IN 47906-6415 | 2016-03-08 |
| 1831580059 | Stephanie Tiller | Specialist/Technologist | 1406 Crusade Dr, West Lafayette, IN 47906-7107 | 2015-02-10 |
| 1720163348 | Andrea Lynn Lopez | Specialist/Technologist | 900 N. University Ave, Room B63, West Lafayette, IN 47907 | 2006-10-25 |
| Find all providers in WEST LAFAYETTE | ||||
| City | WEST LAFAYETTE |
| Zip Code | 47907 |
Please comment or provide details below to improve the information on MR. LUKAS MICHEAL PASSALACQUA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.