Family Medicine, Sports 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 Plan acceptance stays unpublished until the practice reports it.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 1578515151 · enumerated 2006-05-16 · record updated 2016-08-30. 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 SPORTS MEDICINE SOUTH BEND
Addresses and phones
- Mailing address 710 N NILES AVE, SOUTH BEND, IN, 46617-1924 (574) 647-1610 Google Maps Apple Maps OpenStreetMap
- Practice location 111 W JEFFERSON BLVD, SUITE 100, SOUTH BEND, IN, 46601-1994 (574) 647-1669 Fax (574) 239-6461 Google Maps Apple Maps OpenStreetMap
Specialties
- Family Medicine, Sports Medicine 207QS0010X · Primary · License 01049328A IN
In this directory
IN St. Joseph County South Bend Family Medicine, Sports Medicine
Locations and evidence
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Practice location
SOUTH BEND, IN, 466011994
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.