MEDICARE: INNOVATIVE PROSTHETICS & ORTHOTICS

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	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	09896	OTHER	NE	BLUE CROSS BLUE SHIELD
3	F228642	OTHER	NE	MIDLANDS CHOICE

General Provider Information

NPI Number	:	1609940782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNOVATIVE PROSTHETICS & ORTHOTICS

Provider Business Mailing Address
First Line	:	2130 S 17TH ST
Second Line	:	SUITE 100
City	:	LINCOLN
State	:	NE
Zip	:	68502-3750
Country	:	US
Telephone Number	:	402-461-4931
Fax Number	:

Provider Business Practice Location Address
First Line	:	2130 S 17TH ST
Second Line	:	SUITE 100
City	:	LINCOLN
State	:	NE
Zip	:	68502-3750
Country	:	US
Telephone Number	:	402-461-4931
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ASHVINI SENGAR
Credential	:	MD
Telephone Number	:	402-460-5899

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	05/08/2008

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Directions to “INNOVATIVE PROSTHETICS & ORTHOTICS ” Practice Location

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