BEACON MEDICAL GROUP, INC. – NPI #1710939608
Obstetrics & Gynecology

An obstetrician/gynecologist who cares for, or provides consultation on, patients with complications of pregnancy. This specialist has advanced knowledge of the obstetrical, medical and surgical complications of pregnancy and their effect on both the mother and the fetus. The specialist also possesses expertise in the most current diagnostic and treatment modalities used in the care of patients with complicated pregnancies.

BEACON MEDICAL GROUP, INC. is a provider located in SOUTH BEND, IN. NPPES has assigned the NPI number 1710939608 to BEACON MEDICAL GROUP, INC. on May 17, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207VM0101X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology, specializing in Maternal & Fetal Medicine Please note, simply having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Feb 10, 2026. 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
1710939608
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
100 NAVARRE PL STE 4410
SOUTH BEND, IN 46601-1171
Phone: (574) 647-6370 Fax: (574) 647-6373
Mailing address
3245 HEALTH DR STE 100
GRANGER, IN 46530-1380
Phone: (574) 647-3725 Fax:
Organization Subpart
No
Authorized Official
JEFFREY COSTELLO
VP-CFO
Phone: (574) 647-3549
Updated
Certification Date
Feb 10, 2026

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.

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
medicaidIN300125576
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.

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.