Healthcare Provider Details

I. General information

NPI: 1528123007
Provider Name (Legal Business Name): ORTHOPAEDIC SURGICAL CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/26/2006
Last Update Date: 06/13/2025
Certification Date: 06/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 W 89TH AVE STE W5
MERRILLVILLE IN
46410-7050
US

IV. Provider business mailing address

7904 CABELA DR
HAMMOND IN
46324-2950
US

V. Phone/Fax

Practice location:
  • Phone: 219-662-2279
  • Fax: 855-742-9438
Mailing address:
  • Phone: 219-662-2279
  • Fax: 855-742-9483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JOHN POMPONI
Title or Position: PRESIDENT
Credential: D.O.
Phone: 219-662-2279