Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Beacon Medical Group, Inc.

Q: What is the NPI number for Beacon Medical Group, Inc.?

The NPI for Beacon Medical Group, Inc. is 1124079330, a Type 2 (organization) record in the CMS NPPES registry.

Family Medicine Physician in South Bend, IN · enumerated 2006 · authorized official Jeffrey Costello, Vp-Cfo.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1124079330

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Registry record

Entity type Organization (Type 2)

Legal business name Beacon Medical Group, Inc.

Other name <Unavail>

Practice address 1815 E Ireland Rd, South Bend, IN, 46614

Phone (574) 647-1700

Fax (574) 291-3351

Enumeration date May 12, 2006

Last updated in NPPES Jun 25, 2026

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians · License 01043622A (IN) Primary

207QS0010X Sports Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians Secondary

207R00000X Internal Medicine Physician Allopathic & Osteopathic Physicians Secondary

207RI0011X Interventional Cardiology Physician Allopathic & Osteopathic Physicians Secondary

207RR0500X Rheumatology Physician Allopathic & Osteopathic Physicians Secondary

207T00000X Neurological Surgery Physician Allopathic & Osteopathic Physicians Secondary

2085U0001X Diagnostic Ultrasound Physician Allopathic & Osteopathic Physicians Secondary

363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary

363LF0000X Family Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Jeffrey Costello

Title Vp-Cfo

Phone (574) 647-3549

Other identifiers

Identifier	Type	State	Issuer
100224050B	Medicaid	IN	-
300132559	Medicaid	IN	-

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

Read the full guide → Validate an NPI →

Frequently asked questions

What is the NPI number for Beacon Medical Group, Inc.?

The NPI for Beacon Medical Group, Inc. is 1124079330, a Type 2 (organization) record in the CMS NPPES registry.

Who is the authorized official for Beacon Medical Group, Inc.?

NPPES lists Jeffrey Costello (Vp-Cfo) as the authorized official for this organization.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2026-06-25.