NPIMap

Organization Active NPI

Bionic Prosthetics and Orthotics Group LLC

  • Prosthetic/Orthotic Supplier
  • Mishawaka, IN
National Provider Identifier
1477911550
Registry record updated Sep 23, 2020
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
221 Red Coach Dr Ste D
Mishawaka, IN 46545-8324
Phone
(574) 855-3744
Fax
(574) 485-2406
NPI assigned
Feb 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2020

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

Authorized official

Name
Mr. Sumesh Saxena, C.P., BOCO
Title
President
Phone
(219) 791-9200

Specialties & licenses 1

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

Addresses

Primary practice location

221 Red Coach Dr Ste D
Mishawaka, IN 46545-8324

Mailing address

3803 E Lincoln Hwy
Merrillville, IN 46410-5809
Phone (219) 791-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160407001467 IN DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 5890992523 Practice locations: Mishawaka, IN

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 Orthotics221 Red Coach Dr, Mishawaka, IN 46545-8324(574) 855-3744 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

Locations

221 Red Coach Dr
Ste D
Mishawaka, IN 46545
Phone (574) 855-3744

NPI Registry JSON

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600819200000",
    "number": "1477911550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3803 E LINCOLN HWY",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464105809",
            "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": "221 RED COACH DR STE D",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465458324",
            "telephone_number": "574-855-3744",
            "fax_number": "574-485-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIONIC PROSTHETICS AND ORTHOTICS GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2020-09-23",
        "certification_date": "2020-09-23",
        "status": "A",
        "authorized_official_last_name": "SAXENA",
        "authorized_official_first_name": "SUMESH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-791-9200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P., BOCO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; 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.