Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dominic Prospero

Individual provider Occupational Therapist · NPI 1851898076

Dominic Prospero is an Occupational Therapist in Private Practice in South Bend, Indiana. Qualified in 2017, 9 years ago. Practices with Orthopedic and Sports Medicine Center of Northern Indiana Inc, a 48-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Illinois and Indiana.

Years since qualifying
9
Licensed in
IL, IN
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone: (574) 247-9441
Fax: (574) 247-9442
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 5230 Beck Dr Ste 7, Elkhart, IN 46516-9059 — (584) 247-9441
  • 60160 Bodnar Blvd, Mishawaka, IN 46544-9338 — (574) 247-9441

Specialties & licences

Occupational Therapist (primary) Taxonomy 225X00000X · Licence 31007611A (IN)
Occupational Therapist Taxonomy 225X00000X · Licence 056-012465 (IL)

Record details

NPI number1851898076
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 13, 2018
Last updated in NPPESOctober 12, 2023
Certification dateOctober 12, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOCCUPATIONAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Orthopedic And Sports Medicine Center Of Northern Indiana Inc — 48 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in South Bend