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

Beacon Medical Group, Inc

Organization Family Medicine Physician · NPI 1639129117

Beacon Medical Group, Inc is a Family Medicine Physician in LA Porte, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
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

900 I St
LA Porte, IN 46350-5533
Phone: (219) 324-1700
Fax: (219) 324-1710
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01056419A (IN)
Obstetrics & Gynecology Physician Taxonomy 207V00000X
Nurse Practitioner Taxonomy 363L00000X

Record details

NPI number1639129117
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp-Cfo · (574) 647-3549
Other names Beacon Medical Group Laporte; Beacon Medical Group Laporte
NPI enumeratedMay 12, 2006
Last updated in NPPESMarch 4, 2024
Certification dateMarch 4, 2024
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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