BEACON MEDICAL GROUP, INC. – NPI #1275587149
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

BEACON MEDICAL GROUP, INC. is a provider located in SOUTH BEND, IN. NPPES has assigned the NPI number 1275587149 to BEACON MEDICAL GROUP, INC. on May 22, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 8 years ago on Jul 03, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for BEACON MEDICAL GROUP, INC. below.

NPI Profile for
BEACON MEDICAL GROUP, INC.

NPI Number
1275587149
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
BEACON MEDICAL GROUP, INC.
Primary location
813 S MICHIGAN ST
SOUTH BEND, IN 46601
Phone: (574) 647-2400 Fax: (574) 647-4201
1 Other location(s):
621 Memorial Dr Ste 402
South Bend, IN 46601-1074
Phone: (574) 647-2500
Fax: (574) 647-7140
Mailing address
710 N NILES AVE
SOUTH BEND, IN 46617-1924
Phone: (574) 647-1610 Fax:
Organization Subpart
No
Authorized Official
JEFFREY COSTELLO
VP-CFO
Phone: (574) 647-3549
Updated
Identifiers

Identifiers for BEACON MEDICAL GROUP, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDIN200191560A
MEDICAIDIN200191560B
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)
IN 01022886A

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.