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DR. JACK ITALIANO III DO
NPI 1629606124
Family Medicine - Sports Medicine in New Hyde Park, NY

Active since March 30, 2020PECOS EnrolledAccepts Medicare Assignment
1999 MARCUS AVE STE 202, NEW HYDE PARK, NY 11042(516) 467-8600(646) 754-9820 Get Directions Write a Review

NPPES record last updated: April 2, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 2, 2025, Mar 26, 2025, Sep 19, 2024 and 1 more (4 updates tracked since 2020).

About Dr. Jack Italiano Iii Do NPPES

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

DR. JACK ITALIANO III DO (NPI 1629606124) is an individual sports medicine provider in New Hyde Park, New York, licensed in New York (327932) and active in the NPI registry since March 2020. He is enrolled in Medicare PECOS, is affiliated with Long Island Jewish Medical Center, and is a graduate of New York College Of Osteo Medicine Of New York Institute Of Technology (2020).

NPPES Registry Identity

NPI1629606124
Entity TypeIndividualMale
Primary Taxonomy207QS0010X
Provider Legal NameDR. JACK ITALIANO IIICredential: DO
Location Address1999 MARCUS AVE STE 202New Hyde Park, NY 11042-1021
Mailing Address1999 Marcus Ave Ste 202New Hyde Park, NY 11042-1021 · (516) 467-8600 · Fax (646) 754-9820
Phone(516) 467-8600
Fax(646) 754-9820
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2020
Enumeration DateMarch 30, 2020
Last NPPES UpdateApril 2, 20254 updates tracked since enumeration
NPPES CertifiedApril 2, 2025
✔ NPI 1629606124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QS0010X
License✔ Licensed in NY · 327932
Definition
A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X · License 327932 (NY)
1999 MARCUS AVE STE 202, New Hyde Park, NY 11042
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jack Italiano Iii Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456779750
PECOS Enrollment IDI20240805002222
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.

Medicare Billing Reassignment

Medicare enrollment records show Jack Italiano reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

New York University
1,045 mi
Cardiovascular Disease
3301 QUANTUM BLVD
Boynton Beach, FL 33426
  • Reassigned Medicare billing, New York enrollment
  • 2,450 clinicians in this Medicare group
NPI 1285826438 (877) 648-2964

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
26 services26 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
26 services21 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
16 services11 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
13 services13 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Long Island Jewish Medical Center

Acute Care Hospitals · New Hyde Park, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330195
Location270 - 05 76th AvenueNew Hyde Park, NY 11040 · Nassau County
Emergency services Birthing friendly

Nyu Langone Hospitals

Acute Care Hospitals · New York, NY
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330214
Location550 First AvenueNew York, NY 10016 · New York County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 11042 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$105.06 typical visit price
range $67.40 – $203.53
Typical copayment $26.26 (range $16.85 – $50.88)
Most-billed visit code 99203
Established Patient
$117.62 typical visit price
range $21.66 – $164.45
Typical copayment $29.40 (range $5.41 – $41.11)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

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

DR. MEHUL R SHAH M.D.
Orthopaedic Surgery (Sports Medicine)
1999 MARCUS AVE STE 202
NEW HYDE PARK, NY 11042
Nassau County (516) 467-8600

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Italiano's NPI number?

The NPI number for Jack Italiano is 1629606124. It was assigned to this individual provider in the NPPES registry on March 30, 2020.

Where is Jack Italiano located?

Jack Italiano practices at 1999 Marcus Ave Ste 202, New Hyde Park, NY 11042. The listed phone number is (516) 467-8600.

What is Jack Italiano's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Is Jack Italiano enrolled in Medicare?

Yes. Jack Italiano is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Jack Italiano's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jack Italiano reassigns Medicare benefits to New York University (Boynton Beach, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jack Italiano's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jack Italiano affiliated with any hospitals?

According to CMS data, Jack Italiano is affiliated with Long Island Jewish Medical Center and Nyu Langone Hospitals.

When was this NPI record last updated?

The NPPES record for Jack Italiano was last updated on April 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.