Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Beacon Medical Group, Inc

Organization Internal Medicine Physician · NPI 1114262078

Beacon Medical Group, Inc is an Internal Medicine Physician in Elkhart, Indiana. Registered with an NPI since 2012.

In the registry since
2012
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1506 Osolo Rd Ste C
Elkhart, IN 46514-4122
Phone: (574) 266-6050
Fax: (574) 262-8485
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X

Record details

NPI number1114262078
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Cfo · (574) 647-3549
NPI enumeratedDecember 4, 2012
Last updated in NPPESApril 24, 2023
Certification dateApril 24, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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