Individual provider Active NPI

John Kanitra, MD

  • Vascular Surgery Physician
  • Ypsilanti, MI
National Provider Identifier
1730676362
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
4301504105 Issued in MI
Practice address
5325 Elliott Dr Ste 101
Ypsilanti, MI 48197-8633
Phone
(734) 712-8272
Fax
(734) 887-8945
NPI assigned
Apr 19, 2018
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.154814 OH
Surgery Physician 208600000X 4301504105 MI
Vascular Surgery Physician 2086S0129X 4301504105 MI Primary
Vascular Surgery Physician 2086S0129X BP10084099 TX
Vascular Surgery Physician 2086S0129X 35.154814 OH

Addresses

Primary practice location

5325 Elliott Dr Ste 101
Ypsilanti, MI 48197-8633

Mailing address

24 Frank Lloyd Wright Dr Ste J2000
Ann Arbor, MI 48105-9484
Phone (734) 747-6766

Other practice location 1

3500 Gaston Ave Ste 1013
Dallas, TX 75246-2088
Phone (469) 814-3518

Other practice location 2

272 Hospital Rd Ste 115
Chillicothe, OH 45601-9031
Phone (740) 779-4360

Other practice location 3

3000 Arlington Ave Fl 1
Toledo, OH 43614-2595
Phone (419) 383-3963

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.ctv@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20250531000036 MI Practitioner - Vascular SurgeryPractitioner - General Surgery 7810251808 Reassigns benefits to 1 organization
I20251111002477 OH Practitioner - Vascular SurgeryPractitioner - General Surgery 7810251808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular SurgeryAlso: General Surgery
Education
Michigan State University College of Human Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Iha Health Services CorporationGroup PAC ID 2466351440, 1,149 clinicians

Practice addresses (Care Compare)

128 Van Buren St
Chelsea, MI 48118-1623
Phone (734) 475-8677

19000 St Joes Pkwy
Livonia, MI 48152-1477

2305 Genoa Bus Park Dr
Brighton, MI 48114-7005

44428 Woodward Ave
Suite 102
Pontiac, MI 48341-5009
Phone (734) 712-8700

51341 W Huron River Dr
Trinity Health Iha Medical Group Primary Ca
Van Buren Township, MI 48111-2571
Phone (734) 997-0304

5301 E Huron River Dr
Ypsilanti, MI 48197-1051

5301 McAuley Dr
Ypsilanti, MI 48197-1051

5325 Elliott Dr
Ypsilanti, MI 48197-8633

7575 Grand River Rd
Brighton, MI 48114-9309
Phone (734) 712-7255

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10
Leg revascularization (restoring blood flow)1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.154814OHMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Iha Health Services Corporation Surgery CurrentSince Jul 1, 2025 Accepting new patients
Iha Health Services Corporation Current Accepting new patients
University of Toledo Physicians LLC CurrentSince Dec 2, 2025 Accepting new patients
Iha Health Service Corporation CurrentSince Jul 1, 2025 Accepting new patients
University of Toledo Physicians LLC Surgery CurrentSince Dec 2, 2025 Accepting new patients
Henry Ford Health St. John Hospital Past Accepting new patients
Iha Health Services Corporation Past Accepting new patients

Locations

24 Frank Lloyd Wright Dr
Ann Arbor, MI 48105
Phone (734) 930-7400

2305 Genoa Business Park Dr
Ste 200
Brighton, MI 48114
Phone (810) 494-6840

128 Van Buren St
Chelsea, MI 48118
Phone (734) 475-8677

44428 Woodward Ave
Ste 102
Pontiac, MI 48341
Phone (734) 712-8700

5325 Elliott Dr
Ste 101
Ypsilanti, MI 48197
Phone (734) 712-8272

3000 Arlington Ave
Toledo, OH 43614
Phone (419) 383-3556

3000 Arlington Ave
Fl 1
Toledo, OH 43614
Phone (419) 383-3963

3355 Glendale Ave
Toledo, OH 43614
Phone (419) 383-5614

Interoperability endpoints

  • Direct secure messaging: jkanitra4533854@direct.trinity-health.org

Organizations & group practices 7

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 3

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1730676362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 FRANK LLOYD WRIGHT DR STE J2000",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481059484",
            "telephone_number": "734-747-6766",
            "fax_number": "734-222-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 ELLIOTT DR STE 101",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481978633",
            "telephone_number": "734-712-8272",
            "fax_number": "734-887-8945"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Gaston Ave Ste 1013",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752462088",
            "country_code": "US",
            "telephone_number": "469-814-3518",
            "fax_number": "469-814-4854",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "272 Hospital Rd Ste 115",
            "address_purpose": "LOCATION",
            "city": "Chillicothe",
            "state": "OH",
            "postal_code": "456019031",
            "country_code": "US",
            "telephone_number": "740-779-4360",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 Arlington Ave Fl 1",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436142595",
            "country_code": "US",
            "telephone_number": "419-383-3963",
            "fax_number": "419-383-6167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KANITRA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-04-19",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.154814",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MI",
            "license": "4301504105",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MI",
            "license": "4301504105",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "BP10084099",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "OH",
            "license": "35.154814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.ctv@adena.medicity.net",
            "affiliation": "N",
            "address_1": "272 Hospital Rd Ste 115",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456019031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

Verify at the official NPI Registry.