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SOUTH BEND ORTHOPAEDIC ASSOCIATES INC. NPI 1669421277


NPI Information

NPI: 1669421277
Provider Name: SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Organization

CLIA Number: 15D0357424

Address:
53880 CARMICHAEL DR
SOUTH BEND, IN
ZIP 46635
Phone: (574) 247-9441
Get Directions

SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. is an orthopaedic surgery in South Bend, IN. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. SOUTH BEND ORTHOPAEDIC ASSOCIATES, INC. NPI is 1669421277. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

53880 CARMICHAEL DR
SOUTH BEND, IN
ZIP 46635-567
Phone: (574) 247-9441
Fax: (574) 247-9442

The provider's authorized official is James P Sieradzki .
The authorized official title is President and has the following contact phone number (574) 247-9441.

The CLIA number assigned to this NPI record is 15D0357424 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/9/2006 and was last updated on 5/11/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207XS0106XOrthopaedic SurgeryHand Surgery50000460AINDIANANo
2207XS0117XOrthopaedic SurgeryOrthopaedic Surgery of the Spine50000460AINDIANANo
3207XX0004XOrthopaedic SurgeryFoot and Ankle Surgery50000460AINDIANANo
42081S0010XPhysical Medicine & RehabilitationSports Medicine50000460AINDIANANo
5207X00000XOrthopaedic Surgery50000460AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1727130MEDICARE PININDIANA
20429450001MEDICARE NSCINDIANA
3100220150AMEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.