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Beacon Medical Group, Inc.

Q: What type of organization is Beacon Medical Group, Inc.?

Beacon Medical Group, Inc. is registered in NPPES as a Sports Medicine (Family Medicine) Physician (its primary provider taxonomy).

Sports Medicine (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

1578515151

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Registry record

Entity type Organization (Type 2)

Legal business name Beacon Medical Group, Inc.

Other name <Unavail>

Practice address 111 W Jefferson Blvd, Suite 100, South Bend, IN, 46601

Phone (574) 647-1669

Fax (574) 239-6461

Enumeration date May 16, 2006

Last updated in NPPES Aug 30, 2016

Taxonomy & classification

207QS0010X Sports Medicine (Family Medicine) Physician Allopathic & Osteopathic Physicians · License 01049328A (IN) Primary

Authorized official

Name Jeffrey Costello

Title Vp-Cfo

Phone (574) 647-3549

Other identifiers

Identifier	Type	State	Issuer
200302560A	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 type of organization is Beacon Medical Group, Inc.?

Beacon Medical Group, Inc. is registered in NPPES as a Sports Medicine (Family Medicine) Physician (its primary provider taxonomy).

What is a Type 2 NPI?

A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2016-08-30.