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

Beacon Medical Group, Inc

Organization Surgery Physician · NPI 1174927131

Beacon Medical Group, Inc is a Surgery Physician in South Bend, Indiana. Registered with an NPI since 2014.

In the registry since
2014
Specialties on file
3
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

621 Memorial Dr Ste 502
South Bend, IN 46601-1075
Phone: (574) 647-5875
Fax: (574) 647-5878
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Trauma Surgery Physician (primary) Taxonomy 2086S0127X
Surgery Physician Taxonomy 208600000X
Vascular Surgery Physician Taxonomy 2086S0129X

Record details

NPI number1174927131
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Cfo · (574) 647-3549
Other names Beacon Medical Group- Trauma And Surgical Services; Beacon Medical Group- Trauma And Surgical Services
NPI enumeratedOctober 20, 2014
Last updated in NPPESApril 24, 2023
Certification dateApril 24, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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