NPIMap

Organization Active NPI

Bionic Prosthetics and Orthotics Group LLC

  • Prosthetic/Orthotic Supplier
  • Portage, MI
National Provider Identifier
1124686704
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
BIONIC PROSTHETICS AND ORTHOTICS GROUP LLC
Practice address
5401 Portage Rd Ste 2
Portage, MI 49002-1736
Phone
(269) 350-5906
Fax
(744) 852-4065
NPI assigned
May 30, 2019
Last updated
Jul 21, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Authorized official

Name
Laura Allen
Title
Contracting Manager
Phone
(336) 482-8231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X Primary

Addresses

Primary practice location

5401 Portage Rd Ste 2
Portage, MI 49002-1736

Mailing address

PO Box 2300
Valparaiso, IN 46384-2300
Phone (219) 791-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190918002567 MI DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 5890992523 Practice locations: Portage, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bionic Prosthetics and Orthotics GR5401 Portage Rd, Portage, MI 49002-1736(269) 350-5906 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom|Lymphedema Compression Treatment Items Accepts assignmentParticipating since Jan 1, 2019

National Provider Directory

National Provider Directory
Tax ID family
Bionic Prosthetics and Orthotics Group LLC33 organizations share this tax ID, including this one

Other organizations with this tax ID 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1559174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784592000000",
    "number": "1124686704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2300",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463842300",
            "telephone_number": "219-791-9200",
            "fax_number": "219-979-6775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 PORTAGE RD STE 2",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490021736",
            "telephone_number": "269-350-5906",
            "fax_number": "744-852-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIONIC PROSTHETICS AND ORTHOTICS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-30",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "CONTRACTING MANAGER",
        "authorized_official_telephone_number": "336-482-8231"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.