Beacon Medical Group, Inc.
NPI 1124079330 · Family Medicine Physician · South Bend, IN
Beacon Medical Group, Inc. is a Family Medicine Physician organization in South Bend, IN (NPI 1124079330).
Provider details
- NPI number
- 1124079330
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Vp-Cfo(574) 647-3549
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
- Rheumatology Physician207RR0500X
Allopathic & Osteopathic Physicians
- Family Nurse Practitioner363LF0000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Beacon Medical Group Ireland Road
- Doing business as
- Beacon Medical Group Ireland Road
Registry dates
- Enumerated
- 2006-05-12
- Last updated
- 2024-09-30
- Certified
- 2024-09-30
Frequently asked questions
- What is Beacon Medical Group, Inc.'s NPI number?
- Beacon Medical Group, Inc.'s National Provider Identifier (NPI) is 1124079330, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Beacon Medical Group, Inc.?
- Beacon Medical Group, Inc. is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Beacon Medical Group, Inc. located?
- Beacon Medical Group, Inc.'s practice location on file with NPPES is 1815 E Ireland Rd, South Bend, IN 46614-2845.
- What is Beacon Medical Group, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Beacon Medical Group, Inc. is (574) 647-1700.
- Who is the authorized official for Beacon Medical Group, Inc.?
- The authorized official listed on Beacon Medical Group, Inc.'s NPPES record is Jeffrey Costello, Vp-Cfo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Beacon Medical Group, Inc.'s NPI active?
- Yes — Beacon Medical Group, Inc.'s NPI (1124079330) is active in the NPPES registry as of the last update on 2024-09-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.