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Beacon Medical Group, Inc.

Psychiatry Physician in South Bend, IN · enumerated 2011 · authorized official Jeffrey Costello, Vp/Cfo.

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

National Provider Identifier

1629376645

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Registry record

Entity type Organization (Type 2)
Legal business name Beacon Medical Group, Inc.
Other name <Unavail>
Practice address 707 N Michigan St Ste 400, South Bend, IN, 46601
Phone (574) 647-8470
Fax (574) 647-8475
Enumeration date Mar 1, 2011
Last updated in NPPES Feb 22, 2024

Taxonomy & classification

207Q00000X Family Medicine Physician Allopathic & Osteopathic Physicians Secondary
2084P0800X Psychiatry Physician Allopathic & Osteopathic Physicians · License 01052982A (IN) Primary
2084P0804X Child & Adolescent Psychiatry Physician Allopathic & Osteopathic Physicians · License 01052982A (IN) Secondary
2084P0805X Geriatric Psychiatry Physician Allopathic & Osteopathic Physicians · License 01052982A (IN) Secondary
363LP0808X Psychiatric/Mental Health 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
201013730A 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.

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Frequently asked questions

Who is the authorized official for Beacon Medical Group, Inc.?
NPPES lists Jeffrey Costello (Vp/Cfo) as the authorized official for this organization.
What is the NPI number for Beacon Medical Group, Inc.?
The NPI for Beacon Medical Group, Inc. is 1629376645, a Type 2 (organization) record in the CMS NPPES registry.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2024-02-22.