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BEACON MEDICAL GROUP BITTERSWEET COMMONS
NPI 1003042318
Family Medicine in Granger, IN

Active since June 02, 2009CLIA Certified · 2 labs
12340 BITTERSWEET COMMONS BLVD W, GRANGER, IN 46530(574) 271-8610(574) 271-8620 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 1, 2022, Jul 24, 2018, Oct 27, 2016 and 1 more (4 updates tracked since 2016).

About Beacon Medical Group Bittersweet Commons NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BEACON MEDICAL GROUP BITTERSWEET COMMONS (NPI 1003042318) is a healthcare organization registered as a family medicine in Granger, Indiana and active in the NPI registry since June 2009. The organization holds 2 active CLIA laboratory certificates and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1003042318
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address12340 BITTERSWEET COMMONS BLVD WGranger, IN 46530-6959
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Phone(574) 271-8610
Fax(574) 271-8620
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJune 2, 2009
Last NPPES UpdateApril 24, 20234 updates tracked since enumeration
NPPES CertifiedApril 24, 2023
✔ NPI 1003042318 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12340 BITTERSWEET COMMONS BLVD W, Granger, IN 46530
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Other Names 1

Doing Business AsBeacon Medical Group Bittersweet Commons

Other Identifiers 2

Other000000631897IN · Anthem
Medicaid100114000FIN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Beacon Medical Group Bittersweet Commons is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

734

Medicare enrollment records show 734 clinicians reassign Medicare billing to Beacon Medical Group Bittersweet Commons, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 478 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 45

Nurse Practitioner188
Family Practice113
Certified Registered Nurse Anesthetist (CRNA)49
Obstetrics/Gynecology49
Internal Medicine42
Neurology29
Pediatric Medicine28
Psychiatry21
37 other specialties215

Nearest to this location (20)

See all 734
Shelley Morris, D.O.
Family Practice
NPI 1376737387
12340 BITTERSWEET COMMONS BLVD W
Granger, IN 46530
(574) 271-8610
✔ PECOS✔ Accepts MedicareSame address
Cynthia Lynn Pascual, M.D.
Family Practice
NPI 1962401091
12340 BITTERSWEET COMMONS BLVD W
Granger, IN 46530
(574) 271-8610
✔ PECOS✔ Accepts MedicareSame address
Mark Schmeltz, DO
Family Practice
NPI 1487653408
12340 BITTERSWEET COMMONS BLVD W
Granger, IN 46530
(574) 271-8610
✔ PECOS✔ Accepts Medicare0.1 mi
Victoria Eichorn, NP
Nurse Practitioner
NPI 1851173181
52500 FIR RD
Granger, IN 46530
(574) 271-0700
✔ PECOS✔ Accepts Medicare2.8 mi
Steven Hanberg, MD
Internal Medicine
NPI 1821180381
3301 COUNTY ROAD 6 E
Elkhart, IN 46514
(574) 264-9635
✔ PECOS✔ Accepts Medicare3.8 mi
Charisse Johnson, MD
Pediatric Medicine
NPI 1134399025
229 FLORENCE AVE STE 233
Granger, IN 46530
(574) 855-4575
✔ PECOS3.9 mi
Jonathan Abiera, DPM
Podiatry
NPI 1689055451
6913 N MAIN ST STE 300
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Dennis Erdman, MD
Emergency Medicine
NPI 1710064241
6913 N MAIN ST
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Kathleen George
Family Practice
NPI 1194305474
6913 N MAIN ST STE 300
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Sara Golden
Nurse Practitioner
NPI 1114378635
6913 N MAIN ST
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Brandon Hopkins
Nurse Practitioner
NPI 1558792382
6913 N MAIN ST
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Chinyama Munakampe, MD
Family Practice
NPI 1770146185
6913 N MAIN ST STE 300
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Olivia Tack, M.D.
Pediatric Medicine
NPI 1255371514
6913 N MAIN ST STE 200
Granger, IN 46530
(574) 647-4540
✔ PECOS✔ Accepts Medicare4.2 mi
Sara Utz
Nurse Practitioner
NPI 1497328504
6913 N MAIN ST
Granger, IN 46530
(574) 647-1550
✔ PECOS✔ Accepts Medicare4.2 mi
David Amrhein, M.D.
Family Practice
NPI 1952509853
6913 N MAIN ST STE 300
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Mary Elizabeth Campbell, MD, MPH
Family Practice
NPI 1942799838
6913 N MAIN ST STE 300
Granger, IN 46530
(574) 647-1500
✔ PECOS✔ Accepts Medicare4.2 mi
Shanna Kautzmann, M.D.
Pediatric Medicine
NPI 1134214240
6913 N MAIN ST STE 200
Granger, IN 46530
(574) 647-4540
✔ PECOS4.2 mi
Nancy Pudlo, MD
Pediatric Medicine
NPI 1467610352
6913 N MAIN ST STE 200
Granger, IN 46530
(574) 647-4540
✔ PECOS4.2 mi
Natali Balog, MD
Rheumatology
NPI 1578552386
6901 N MAIN ST STE 102
Granger, IN 46530
(574) 647-4500
✔ PECOS✔ Accepts Medicare4.2 mi
Maryann Domingo, M.D.
Rheumatology
NPI 1053396127
6901 N MAIN ST STE 102
Granger, IN 46530
(574) 647-4500
✔ PECOS✔ Accepts Medicare4.2 mi
See all 734 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D1101762

Beacon Med Grp Bittersweet Commons · Granger, IN
Active · expires Jul 5, 2027
CLIA Number15D1101762
Laboratory TypePhysician Office
Certificate Effective DateJuly 6, 2025
Certificate Expiration DateJuly 5, 2027
Laboratory DirectorMark P. Schmeltz
Laboratory Phone(574) 271-8610
Laboratory LocationBeacon Med Grp Bittersweet Commons12340 Bittersweet Commons Blvd, Granger, IN 46530
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Certificate of Waiver 15D2004247

Beacon Medical Group Main Street · Granger, IN
Active · expires Jun 1, 2028
CLIA Number15D2004247
Laboratory TypeMed Point Lab
Certificate Effective DateJune 2, 2026
Certificate Expiration DateJune 1, 2028
Laboratory DirectorDr. David Amrhein
Laboratory Phone(574) 647-1507
Laboratory LocationBeacon Medical Group Main Street6913 N Main St, Granger, IN 46530
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Beacon Medical Group, Inc.'s NPI number?

The NPI number for Beacon Medical Group, Inc. is 1003042318. It was assigned to this organization in the NPPES registry on June 2, 2009. The provider is doing business as Beacon Medical Group Bittersweet Commons.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 12340 Bittersweet Commons Blvd W, Granger, IN 46530. The listed phone number is (574) 271-8610.

What is Beacon Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Beacon Medical Group, Inc. enrolled in Medicare?

Yes. Beacon Medical Group, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Beacon Medical Group, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 734 clinicians in 45 Medicare specialties reassign their Medicare billing to Beacon Medical Group, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (188), Family Practice (113) and Certified Registered Nurse Anesthetist (CRNA) (49). Of these, 2 practice at this address and 478 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Beacon Medical Group, Inc. hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield list Beacon Medical Group, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Beacon Medical Group, Inc. was last updated on April 24, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.