BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY – NPI #1770954992
Internal Medicine

An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.

BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY is a provider located in ELKHART, IN. NPPES has assigned the NPI number 1770954992 to BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY on October 14, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY” is a dba name, the actual legal business name for this organization is BEACON MEDICAL GROUP, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207RP1001X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine, specializing in Pulmonary Disease

The NPI profile was previously updated about 3 years ago on Apr 28, 2023. 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 PULMONOLOGY AND GENERAL SURGERY below.

NPI Profile for
BEACON MEDICAL GROUP, INC.

NPI Number
1770954992
Enumeration Date

(more than 10 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.
Doing Business As (dba): BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY
Primary location
500 ARCADE AVE STE 210
ELKHART, IN 46514-2485
Phone: (574) 389-5656 Fax: (574) 523-7891
Mailing address
710 N NILES AVE
SOUTH BEND, IN 46617-1924
Phone: (574) 647-1610 Fax: (574) 237-6069
Organization Subpart
Yes - BEACON MEDICAL GROUP PULMONOLOGY AND GENERAL SURGERY is subpart of another organization.
Authorized Official
JEFFREY COSTELLO
CFO
Phone: (574) 647-3549
Updated
Certification Date
Apr 28, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

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
207RP1001X
- Internal Medicine / Pulmonary Disease (Primary)
208600000X
- Surgery
207R00000X
- Internal Medicine

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.