Bionic Prosthetics and Orthotics Group LLC

Organization Active NPI Prosthetic/Orthotic Supplier · Portage, MI

NPI 1124686704 · NPPES record last updated Jul 21, 2026

Key facts

NPI
1124686704
Entity type
Organization (NPI type 2)
Primary specialty
Prosthetic/Orthotic Supplier 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
Organization subpart
No

Authorized official

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

Corporate family (same tax ID) 32

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

View all 32

Laboratory certificates & supplier records

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

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Bionic Prosthetics and Orthotics GR
5401 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 assignment
Participating since Jan 1, 2019

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

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

National Provider Directory

Tax ID family
Bionic Prosthetics and Orthotics Group LLC (33 organizations share this tax ID)

Locations

5401 Portage Rd
Ste 2
Portage, MI 49002
Phone (269) 350-5906

5401 Portage Rd
Ste 2A
Portage, MI 49002

Specialties & licenses

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

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

Other providers in Portage, MI

All providers in Portage, MI · Prosthetic/Orthotic Supplier in Michigan

Sources for this page

Verify at the official NPI Registry.