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BEACON MEDICAL GROUP, INC.
NPI 1114262078
Internal Medicine in Elkhart, IN

Active since December 04, 2012CLIA Certified · 2 labs
1506 OSOLO RD STE C, ELKHART, IN 46514(574) 266-6050(574) 262-8485 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1114262078) is a healthcare organization registered as an internal medicine in Elkhart, Indiana and active in the NPI registry since December 2012. The organization holds 2 active CLIA laboratory certificates and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1114262078
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address1506 OSOLO RD STE CElkhart, IN 46514-4122
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 266-6050 · Fax (574) 262-8485
Phone(574) 266-6050
Fax(574) 262-8485
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateDecember 4, 2012
Last NPPES UpdateApril 24, 2023
NPPES CertifiedApril 24, 2023
✔ NPI 1114262078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1506 OSOLO RD STE C, Elkhart, IN 46514
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Other Identifiers 1

Medicaid201120750BIN

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 Anthem Blue Cross and Blue Shield.Insurance ›

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 of Waiver 15D2274982

Beacon Medical Group Obgyn River Oaks · Elkhart, IN
Active · expires Jan 12, 2027
CLIA Number15D2274982
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorStarla D. Graber
Laboratory Phone(574) 295-8805
Laboratory LocationBeacon Medical Group Obgyn River Oaks2405 West Lexington Avenue, Elkhart, IN 46514
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 15D2274998

Beacon Medical Group Obgyn River Oaks Lawn Avenue · Elkhart, IN
Active · expires Jan 12, 2027
CLIA Number15D2274998
Laboratory TypePhysician Office
Certificate Effective DateJanuary 13, 2025
Certificate Expiration DateJanuary 12, 2027
Laboratory DirectorStarla D. Graber
Laboratory Phone(574) 294-8750
Laboratory LocationBeacon Medical Group Obgyn River Oaks Lawn Avenue1215 Lawn Avenue Suite 110, Elkhart, IN 46514
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 1114262078. It was assigned to this organization in the NPPES registry on December 4, 2012.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 1506 Osolo Rd Ste C, Elkhart, IN 46514. The listed phone number is (574) 266-6050.

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

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

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 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.