OrganizationActive
Beacon Medical Group, Inc.
NPI 1770775009 · Radiation Oncology Physician · South Bend, IN
Provider details
- NPI number
- 1770775009
- Entity type
- Organization
- Primary specialty
- Radiation Oncology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jeffrey Costello, Vp-Cfo(574) 647-3549
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Hematology & Oncology Physician207RH0003X
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(93/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
621 Memorial Dr Ste 100
South Bend, IN 46601-1063
Phone: (574) 647-1100
Fax: (574) 647-5907
Approximate (ZIP-level) locationGet directions
Mailing address
710 N Niles Ave
South Bend, IN 46617-1924
Other names (DBA / former)
- Doing business as
- Beacon Medical Group Oncology Elkhart
- Doing business as
- Beacon Medical Group Oncology South Bend
Additional practice locations (1)
- 1215 Lawn Ave Ste 120Elkhart, IN 46514-2450Phone: (574) 523-2733Fax: (574) 523-3251
Registry dates
- Enumerated
- 2007-08-10
- Last updated
- 2023-04-28
- Certified
- 2023-04-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.