John Jeffrey Italiano, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

5101027462 Issued in MI

Practice address

6157 28TH St SE Ste 18B
Grand Rapids, MI 49546-6947

Phone

(616) 282-5969

NPI assigned

Apr 26, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 30, 2025 through Oct 30, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Interoperability endpoints

• Direct secure messaging: jitaliano1836807@direct.trinity-health.org

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767312000000",
    "number": "1316681232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6157 28TH ST SE STE 18B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466947",
            "telephone_number": "616-282-5969",
            "fax_number": "616-276-6089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6157 28TH ST SE STE 18B",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495466947",
            "telephone_number": "616-282-5969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ITALIANO",
        "first_name": "JOHN",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-26",
        "last_updated": "2026-01-02",
        "certification_date": "2026-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MI",
            "license": "5101027462",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101027462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathea Kennedy Ismond, BSW
• Abish Zitlatlic Israde
• Emma Israels
• Nene N/a Issa
• Raquel Italia
• Ivf Laboratories of Grand Rapids, LLC
• Mary Christine Ivie-Scoggins, LMSW, CAADC
• Ivy Leaf Counseling PLLC
• Markian R Iwaszko, MD
• Carlee Jo Iwema, LLPC

• Family Medicine Physician in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.