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

Beacon Medical Group, Inc

Organization Psychologist · NPI 1548415474

Beacon Medical Group, Inc is a Psychologist in South Bend, Indiana. Works from 2 locations. Licensed in Indiana.

Licensed in
IN
In the registry since
2008
Specialties on file
7
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

100 Navarre Pl Ste 5550
South Bend, IN 46601-1169
Phone: (574) 647-2550
Fax: (574) 647-1129
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 100 Navarre Pl Ste 5570, South Bend, IN 46601-1169 — (574) 647-8610

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 01065535A (IN)
Psychologist Taxonomy 103T00000X
Clinical Psychologist Taxonomy 103TC0700X
Registered Dietitian Taxonomy 133V00000X
Neonatal-Perinatal Medicine Physician Taxonomy 2080N0001X
Pediatric Pulmonology Physician Taxonomy 2080P0214X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1548415474
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vice President/Cfo · (574) 647-3549
Other names Beacon Medical Group Pediatric Multi-Specialty; Beacon Medical Group Pediatric Multi-Specialty; Beacon Medical Group Pediatric Specialists
NPI enumeratedNovember 19, 2008
Last updated in NPPESJuly 21, 2025
Certification dateJuly 21, 2025
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

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