OrganizationActive
Beacon Medical Group, Inc.
NPI 1770954992 · Pulmonary Disease Physician · Elkhart, IN
Provider details
- NPI number
- 1770954992
- Entity type
- Organization
- Primary specialty
- Pulmonary Disease PhysicianAllopathic & Osteopathic Physicians
- Parent organization
- Beacon Health System, Inc.
- Organization subpart
- Yes
- Authorized official
- Jeffrey Costello, Cfo(574) 647-3549
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 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
500 Arcade Ave Ste 210
Elkhart, IN 46514-2485
Phone: (574) 389-5656
Fax: (574) 523-7891
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 Pulmonology and General Surgery
Registry dates
- Enumerated
- 2015-10-14
- 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.