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 1770954992

Beacon Medical Group, Inc is an Internal Medicine Physician in Elkhart, Indiana. Registered with an NPI since 2015.

In the registry since
2015
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

500 Arcade Ave Ste 210
Elkhart, IN 46514-2485
Phone: (574) 389-5656
Fax: (574) 523-7891
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pulmonary Disease Physician (primary) Taxonomy 207RP1001X
Internal Medicine Physician Taxonomy 207R00000X
Surgery Physician Taxonomy 208600000X

Record details

NPI number1770954992
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationBeacon Health System, Inc
Authorized official Jeffrey Costello — Cfo · (574) 647-3549
Other names Beacon Medical Group Pulmonology And General Surgery
NPI enumeratedOctober 14, 2015
Last updated in NPPESApril 28, 2023
Certification dateApril 28, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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