Individual provider Active NPI

John B Riley, DO

  • Facial Plastic Surgery Physician
  • Grand Rapids, MI
National Provider Identifier
1629573662
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
5101027426 Issued in MI
Practice address
739 E Beltline Ave NE
Grand Rapids, MI 49525-6045
Phone
(616) 994-2770
Fax
(616) 920-6533
NPI assigned
Mar 29, 2018
Last updated
Nov 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Facial Plastic Surgery Physician 207YS0123X 5101027426 MI Primary

Addresses

Primary practice location

739 E Beltline Ave NE
Grand Rapids, MI 49525-6045

Mailing address

3100 N Wellness Dr
Holland, MI 49424-8122
Phone (164) 336-0036

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jriley413215@direct.hfhs.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230706003710 MI Practitioner - Otolaryngology 7517214679 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Michigan State University College of Osteopathic Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Michigan Ear Nose Throat and Allergy Specialists PCGroup PAC ID 4183868094, 42 clinicians

Practice addresses (Care Compare)

739 E Beltline Ave NE
Grand Rapids, MI 49525-6001
Phone (616) 994-2770

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.85 of 100Reported as group
Quality
81.22
Promoting interoperability
100
Improvement activities
40
Cost
71.61

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Michigan Ear, Nose, Throat, and Allergy Specialists, PC CurrentSince Aug 14, 2023 Accepting new patients
West Michigan Surgical Center, LLC Past Accepting new patients

Locations

6470 Cherry Meadow Dr SE
Caledonia, MI 49316

17168 Timber View Dr
Grand Haven, MI 49417
Phone (616) 414-3088

739 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 949-3667

3501 Rivertown Point Ct SW
Grandville, MI 49418
Phone (616) 396-1433

3100 N Wellness Dr
Holland, MI 49424
Phone (616) 396-1433

Interoperability endpoints

  • Direct secure messaging: jriley1252951@epic00.corewelldirect.org
  • Direct secure messaging: jriley2835842@direct.trinity-health.org
  • Direct secure messaging: jriley413215@direct.hfhs.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1629573662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 N WELLNESS DR",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248122",
            "telephone_number": "164-336-0036",
            "fax_number": "616-920-6533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "739 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495256045",
            "telephone_number": "616-994-2770",
            "fax_number": "616-920-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RILEY",
        "first_name": "JOHN",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MI",
            "license": "5101027426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jriley413215@direct.hfhs.org",
            "affiliation": "N",
            "address_1": "15855 19 Mile Rd",
            "city": "Clinton Township",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480383504",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.