Innovative Prosthetic Solutions, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

INNOVATIVE PROSTHETIC SOLUTIONS, INC

Practice address

2 S Pointe Dr Ste 240
Lake Forest, CA 92630-2281

Phone

(949) 699-0600

NPI assigned

Dec 9, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Jon Tyra Rikimaru, CPONPI 1952255770

Title

President

Phone

(949) 699-0600

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

Locations

Practitioners 1

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

• Jon Tyra Rikimaru, CPO

  • Prosthetist
  • Lake Forest, CA
  • NPI 1952255770
  NPD Authorized official

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757462400000",
    "number": "1487639647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 S POINTE DR STE 240",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302281",
            "telephone_number": "949-699-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 S POINTE DR STE 240",
            "city": "LAKE FOREST",
            "state": "CA",
            "postal_code": "926302281",
            "telephone_number": "949-699-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PROSTHETIC SOLUTIONS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-09",
        "last_updated": "2025-09-10",
        "certification_date": "2025-09-10",
        "status": "A",
        "authorized_official_last_name": "RIKIMARU",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "TYRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-699-0600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XC0010901",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF CA",
            "identifier": "ZZZ65372Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Prosthetic/Orthotic Supplier in Lake Forest, CA
• Providers in Lake Forest, CA by specialty
• Prosthetic/Orthotic Supplier in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2025; 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.