Family Medicine
BEACON MEDICAL GROUP, INC.
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1568413359 · enumerated 2006-05-15 · record updated 2013-09-27. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: JEFFREY COSTELLO, VP-CFO · (574) 647-3549
Other names: BEACON MEDICAL GROUP PORTAGE ROAD
Addresses and phones
- Practice location 3575 PORTAGE AVE, SOUTH BEND, IN, 46628-6092 (574) 647-4530 Google Maps Apple Maps OpenStreetMap
- Mailing address 53842 GENERATIONS DR, SOUTH BEND, IN, 46635-1543 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine 207Q00000X · Primary · License 01054535A IN
In this directory
Locations and evidence
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Practice location
SOUTH BEND, IN, 466286092
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.