OrganizationActive
Beacon Medical Group, Inc.
NPI 1437100161 · Family Medicine Physician · South Bend, IN
Provider details
- NPI number
- 1437100161
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Vp-Cfo(574) 647-3549
- License
- 01059718A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(91/100 index)
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
1708 High St
South Bend, IN 46613-2633
Phone: (574) 647-1400
Street-level locationGet directions
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Other names (DBA / former)
- Doing business as
- Beacon Medical Group Southeast Neighborhood Health Center
Registry dates
- Enumerated
- 2006-05-15
- Last updated
- 2016-08-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.