MEDICARE: CENTRAL INDIANA ORTHOPEDICS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081S0010X	Sports Medicine (Physical Medicine & Rehabilitation) Physician
2	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1265209456
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL INDIANA ORTHOPEDICS, LLC

Provider Business Mailing Address
First Line	:	3600 W BETHEL AVE
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47304-5407
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2349 LAKE AVE STE 201
Second Line	:
City	:	PLYMOUTH
State	:	IN
Zip	:	46563-7837
Country	:	US
Telephone Number	:	574-247-9441
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	VICTOR MORAN
Credential	:
Telephone Number	:	765-284-7738

Provider Enumeration Date	:	12/07/2023
Last Update Date	:	07/23/2024

Similar Medicare Providers

1225082878 — SAINT JOSEPH REGIONAL MEDICAL CENTER, INC.
Practice Location Address:

2349 LAKE AVE STE 99
PLYMOUTH, IN
46563-7837

Practice Phone: 574-948-5340
Practice Fax: 574-948-5494

1598700122 — DR. RAJINDRA KUMAR SARIN M.B.B.S.
Practice Location Address:

2349 LAKE AVE STE 201
PLYMOUTH, IN
46563-7837

Practice Phone: 574-941-2977
Practice Fax:

1679592828 — DR. FRANK A ADDO MD
Practice Location Address:

2349 LAKE AVE STE 99
PLYMOUTH, IN
46563-7837

Practice Phone: 574-948-5340
Practice Fax: 574-948-5494

1790347524 — JEANA RENEE BERGER MSN, FNP-C
Practice Location Address:

2855 MILLER DR STE 117
PLYMOUTH, IN
46563-8091

Practice Phone: 574-316-8010
Practice Fax: 574-316-8003

1538585187 — SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC
Practice Location Address:

1919 LAKE AVE STE 102B
PLYMOUTH, IN
46563-7830

Practice Phone: 574-335-6800
Practice Fax: 574-948-5480

1821402876 — SAINT JOSEPH REGIONAL MEDICAL CENTER- PLYMOUTH CAMPUS INC
Practice Location Address:

1915 LAKE AVE
PLYMOUTH, IN
46563-9366

Practice Phone: 574-948-4000
Practice Fax: 574-948-5454

Directions to “CENTRAL INDIANA ORTHOPEDICS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.