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

Beacon Medical Group, Inc

Organization Aerospace Medicine Physician · NPI 1780856724

Beacon Medical Group, Inc is an Aerospace Medicine Physician in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2008.

Licensed in
IN
In the registry since
2008
Specialties on file
2
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

2301 N Bendix Dr Ste 500
South Bend, IN 46628-3486
Phone: (574) 647-1675
Fax: (574) 232-5595
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Aerospace Medicine Physician (primary) Taxonomy 2083A0100X · Licence 01047560A (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 71000502A (IN)

Record details

NPI number1780856724
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp/Cfo · (574) 647-3549
Other names Beacon Medical Group Occupational Health South Bend
NPI enumeratedMarch 31, 2008
Last updated in NPPESAugust 30, 2016
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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