BEACON MEDICAL GROUP, INC.
NPI 1053361543
Family Medicine in Granger, IN

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

The NPI number for Beacon Medical Group, Inc. is 1053361543. It was assigned to this organization in the NPPES registry on May 12, 2006. The provider is doing business as Beacon Medical Group Main Street and Beacon Medical Group Pediatrics Main Street.

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

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

Active since May 12, 2006

6913 N MAIN ST STE 300, GRANGER, IN 46530(574) 647-1500(574) 647-2567 Get Directions Write a Review

NPPES record last updated: June 12, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 4, 2024, Mar 9, 2021, Jun 27, 2018 and 1 more (4 updates tracked since 2016).

On this page

About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1053361543), doing business as Beacon Medical Group Main Street, is a healthcare organization registered as a family medicine in Granger, Indiana and active in the NPI registry since May 2006. The organization maintains 2 additional practice locations and lists Jeffrey Costello, Vp-cfo, as its authorized official.

NPPES Registry Identity

NPI1053361543

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBEACON MEDICAL GROUP, INC.

Location Address6913 N MAIN ST STE 300Granger, IN 46530-8039

Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380

Phone(574) 647-1500

Fax(574) 647-2567

Organization SubpartNo

Authorized OfficialJeffrey CostelloVp-cfo · (574) 647-3549

Enumeration DateMay 12, 2006

Last NPPES UpdateJune 12, 20264 updates tracked since enumeration

NPPES CertifiedJune 12, 2026

✔ NPI 1053361543 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ 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.

Also ListedDietitian, RegisteredTaxonomy 133V00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X

Also ListedInternal Medicine · RheumatologyTaxonomy 207RR0500X

Also ListedPediatricsTaxonomy 208000000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

6913 N MAIN ST STE 300, Granger, IN 46530

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Other Names 2

Doing Business AsBeacon Medical Group Main Street

Doing Business AsBeacon Medical Group Pediatrics Main Street

Secondary Practice Locations 2

Location 16913 N Main St Ste 200Granger, IN 46530-8039 · Phone (574) 647-2567 · Fax (574) 647-2971

Location 26901 N Main St Ste 102Granger, IN 46530-8022 · Phone (574) 647-4500 · Fax (574) 647-6354

Other Identifiers 3

Medicaid300002852IN

Medicaid100224050CIN

Medicaid300015362IN

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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, Inc. 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, Inc., which bills Medicare for the services they deliver. Of these, 21 practice at this address and 387 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

Jonathan Abiera, DPM

Podiatry

NPI 1689055451

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Dennis Erdman, MD

Emergency Medicine

NPI 1710064241

6913 N MAIN ST
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Kathleen George

Family Practice

NPI 1194305474

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Sara Golden

Nurse Practitioner

NPI 1114378635

6913 N MAIN ST
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Brandon Hopkins

Nurse Practitioner

NPI 1558792382

6913 N MAIN ST
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Chinyama Munakampe, MD

Family Practice

NPI 1770146185

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Olivia Tack, M.D.

Pediatric Medicine

NPI 1255371514

6913 N MAIN ST STE 200
Granger, IN 46530

(574) 647-4540

✔ PECOS✔ Accepts MedicareSame address

Sara Utz

Nurse Practitioner

NPI 1497328504

6913 N MAIN ST
Granger, IN 46530

(574) 647-1550

✔ PECOS✔ Accepts MedicareSame address

Megan Vermilyer

Nurse Practitioner

NPI 1033524905

6913 N MAIN ST
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Natali Balog, MD

Rheumatology

NPI 1578552386

6901 N MAIN ST STE 102
Granger, IN 46530

(574) 647-4500

✔ PECOS✔ Accepts MedicareSame address

Maryann Domingo, M.D.

Rheumatology

NPI 1053396127

6901 N MAIN ST STE 102
Granger, IN 46530

(574) 647-4500

✔ PECOS✔ Accepts MedicareSame address

David Amrhein, M.D.

Family Practice

NPI 1952509853

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Sherri Biever, FNP

Nurse Practitioner

NPI 1982691747

6913 N MAIN ST STE 200
Granger, IN 46530

(574) 647-4540

✔ PECOSSame address

Mary Elizabeth Campbell, MD, MPH

Family Practice

NPI 1942799838

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Scott Eshowsky, M.D.

Family Practice

NPI 1285622373

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Shanna Kautzmann, M.D.

Pediatric Medicine

NPI 1134214240

6913 N MAIN ST STE 200
Granger, IN 46530

(574) 647-4540

✔ PECOSSame address

Andrew Mcafee, M.D.

Family Practice

NPI 1558395079

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

Madison Parker, NP

Nurse Practitioner

NPI 1407580533

6913 N MAIN ST STE 200
Granger, IN 46530

(574) 647-4540

✔ PECOS✔ Accepts MedicareSame address

Nancy Pudlo, MD

Pediatric Medicine

NPI 1467610352

6913 N MAIN ST STE 200
Granger, IN 46530

(574) 647-4540

✔ PECOSSame address

Basman Salous, M.D.

Family Practice

NPI 1982687521

6913 N MAIN ST STE 300
Granger, IN 46530

(574) 647-1500

✔ PECOS✔ Accepts MedicareSame address

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.

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 1053361543. It was assigned to this organization in the NPPES registry on May 12, 2006. The provider is doing business as Beacon Medical Group Main Street and Beacon Medical Group Pediatrics Main Street.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 6913 N Main St Ste 300, Granger, IN 46530. The listed phone number is (574) 647-1500.

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, 21 practice at this address and 387 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource 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 June 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.