NPIMap

Orthopedic and Sports Medicine Center of Northern Indiana, Inc.

Organization Active NPI Prosthetic/Orthotic Supplier · Elkhart, IN

NPI 1043425564 · NPPES record last updated Jul 29, 2026

Key facts

NPI
1043425564
Entity type
Organization (NPI type 2)
Primary specialty
Prosthetic/Orthotic Supplier 335E00000X
License
50000745A (IN)
Legal business name
ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA, INC.
Practice address
2310 California Rd Ste a
Elkhart, IN 46514-1228
Phone
(574) 264-0791
Fax
(574) 262-9650
NPI assigned
May 10, 2007
Organization subpart
No

Authorized official

Name
Heidi S. Schaffer
Title
Coo
Phone
(574) 264-0791

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 46

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20100930013138 IN DME Supplier - Physician - Orthopedic/Orthopedic Surgery 0840260105 Practice locations: Elkhart, IN

National Provider Directory

Tax ID family
Orthopedic Sports Med CNTR (3 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 50000745A IN Yes

Addresses

Primary practice location

2310 California Rd Ste a
Elkhart, IN 46514-1228

Mailing address

2310 California Rd Ste a
Elkhart, IN 46514-1228
Phone (574) 264-0791

Other identifiers

IdentifierTypeStateIssuer
100111780AMedicaidIN
300024175MedicaidIN

Other names

  • Orthopedic & Sports Medicine Center Doing business as
  • Orthopedic & Sports Medicine Center (OSMC) Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 29, 2026.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785283200000",
    "number": "1043425564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-264-0791",
            "fax_number": "574-262-9650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 CALIFORNIA RD STE A",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465141228",
            "telephone_number": "574-264-0791",
            "fax_number": "574-262-9650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC AND SPORTS MEDICINE CENTER OF NORTHERN INDIANA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-10",
        "last_updated": "2026-07-29",
        "certification_date": "2026-07-29",
        "status": "A",
        "authorized_official_last_name": "SCHAFFER",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "574-264-0791"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IN",
            "license": "50000745A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100111780A",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "300024175",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthopedic & Sports Medicine Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthopedic & Sports Medicine Center (OSMC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkhart, IN

All providers in Elkhart, IN · Prosthetic/Orthotic Supplier in Indiana

Sources for this page

Verify at the official NPI Registry.