MEDICARE: INNOVATIVE ORTHOPEDIC SOLUTIONS 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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1366326563
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE ORTHOPEDIC SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	4914 COOPER RD UNIT 42155
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45242-2507
Country	:	US
Telephone Number	:	813-469-8254
Fax Number	:

Provider Business Practice Location Address
First Line	:	4625 RED BANK RD STE 101
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45227-1528
Country	:	US
Telephone Number	:	513-525-1234
Fax Number	:	513-525-1231

Authorized Official
Title or Position	:	OWNER
Name	:	JAMES TREVOR STEFANSKI
Credential	:
Telephone Number	:	513-525-1234

Provider Enumeration Date	:	08/01/2025
Last Update Date	:	01/13/2026

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