Individual provider Active NPI

Jonathan S Stewart, OTR

  • Occupational Therapist
  • South Bend, IN
National Provider Identifier
1225512494
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31006706A Issued in IN
Practice address
53880 Carmichael Dr
South Bend, IN 46635-1567
Phone
(574) 247-9441
Fax
(574) 247-9442
NPI assigned
Sep 24, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31006706A IN Primary

Addresses

Primary practice location

53880 Carmichael Dr
South Bend, IN 46635-1567

Mailing address

3600 W Bethel Ave
Muncie, IN 47304-5407

Other practice location 1

60160 Bodnar Blvd
Mishawaka, IN 46544-9338
Phone (574) 247-9441

Other practice location 2

5230 Beck Dr Ste 7
Elkhart, IN 46516-9059
Phone (574) 247-9441

Other identifiers 2

IdentifierTypeStateIssuer
201029990MedicaidIN
31006706AOtherINSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181010000933 IN Practitioner - Occupational Therapist in Private Practice 3971855594 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Indiana Orthopedics LLCGroup PAC ID 5698667822, 148 clinicians

Practice addresses (Care Compare)

53880 Carmichael Dr
South Bend, IN 46635-1567
Phone (317) 455-1064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Central Indiana Orthopedics LLC Occupational Therapist CurrentSince Mar 1, 2025 Accepting new patients
Beltway Surgery Centers LLC Current Accepting new patients
Indiana University Health Ambulatory Surgery Centers, LLC Current Accepting new patients
Central Indiana Orthopedics, LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

5230 Beck Dr
Ste 7
Elkhart, IN 46516
Phone (574) 274-9441

8501 Harcourt Rd
Indianapolis, IN 46260
Phone (317) 471-4339

60160 Bodnar Blvd
Mishawaka, IN 46544
Phone (574) 247-2790

3600 W Bethel Ave
Muncie, IN 47304
Phone (765) 213-3870

53880 Carmichael Dr
South Bend, IN 46635
Phone (574) 234-1159

Interoperability endpoints

  • Direct secure messaging: jonathan.stewart.p4@direct.beaconortho.nextgenshare.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1225512494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W BETHEL AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473045407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53880 CARMICHAEL DR",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466351567",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60160 Bodnar Blvd",
            "address_purpose": "LOCATION",
            "city": "Mishawaka",
            "state": "IN",
            "postal_code": "465449338",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5230 Beck Dr Ste 7",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465169059",
            "country_code": "US",
            "telephone_number": "574-247-9441",
            "fax_number": "574-247-9442",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "JONATHAN",
        "middle_name": "S",
        "credential": "OTR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-24",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31006706A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201029990",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "31006706A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.