Organization Active NPI

Tom Watson'S Prosthetics and Orthotics Lab, Inc.

  • Prosthetic/Orthotic Supplier
  • Evansville, IN
National Provider Identifier
1649545641
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
Legal business name
TOM WATSON'S PROSTHETICS AND ORTHOTICS LAB, INC.
Practice address
2616 S. Green River Rd.
Evansville, IN 47715-6718
Phone
(812) 471-1234
Fax
(812) 471-1234
NPI assigned
Mar 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Authorized official

Name
Sumesh Saxena
Title
Owner of Bionic
Phone
(219) 791-9200

Specialties & licenses 1

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

Addresses

Primary practice location

2616 S. Green River Rd.
Evansville, IN 47715-6718

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
O20120829000139 IN DME Supplier - Prosthetic PersonnelDME Supplier - Orthotic Personnel 9537286976 Practice locations: Evansville, IN

Other NPIs with the same Medicare PAC ID 1

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

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
Tom Watson'S Prosthetics & Orthotic2616 S Green River Rd, Evansville, IN 47715-6718(812) 471-1234 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 Does not accept assignmentParticipating since Jan 1, 1998

National Provider Directory

National Provider Directory
Tax ID family
Bionic Prosthetics and Orthotics Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2616 S Green River Rd
Evansville, IN 47715
Phone (812) 471-1234

NPI Registry JSON

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

{
    "created_epoch": "1331251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675641600000",
    "number": "1649545641",
    "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": "312-268-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2616 S. GREEN RIVER RD.",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477156718",
            "telephone_number": "812-471-1234",
            "fax_number": "812-471-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOM WATSON'S PROSTHETICS AND ORTHOTICS LAB, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-09",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A",
        "authorized_official_last_name": "SAXENA",
        "authorized_official_first_name": "SUMESH",
        "authorized_official_title_or_position": "OWNER OF BIONIC",
        "authorized_official_telephone_number": "219-791-9200"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; 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.