Healthcare Provider Details

I. General information

NPI: 1124686704
Provider Name (Legal Business Name): BIONIC PROSTHETICS AND ORTHOTICS GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2019
Last Update Date: 09/15/2025
Certification Date: 09/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5401 PORTAGE RD STE 2
PORTAGE MI
49002-1736
US

IV. Provider business mailing address

8695 CONNECTICUT ST STE E
MERRILLVILLE IN
46410-6240
US

V. Phone/Fax

Practice location:
  • Phone: 269-350-5906
  • Fax: 744-852-4065
Mailing address:
  • Phone: 219-791-9200
  • Fax: 219-979-6775

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State

VIII. Authorized Official

Name: MR. SUMESH SAXENA
Title or Position: PRESIDENT
Credential: C.P., BOCO
Phone: 219-840-5595