BEACON MEDICAL GROUP MIDDLEBURY
NPI 1114363835
Family Medicine in Middlebury, IN
About Beacon Medical Group Middlebury NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEACON MEDICAL GROUP MIDDLEBURY (NPI 1114363835) is a healthcare organization registered as a family medicine in Middlebury, Indiana and active in the NPI registry since May 2013. The organization holds a CLIA Waiver certificate valid through June 19, 2028 and lists Jeffrey P. Costello, Cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted 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 Middlebury is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
734Medicare enrollment records show 734 clinicians reassign Medicare billing to Beacon Medical Group Middlebury, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 8 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 45
Nearest to this location (20)
See all 734Source: 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
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 15D0356768
Beacon Med Grp - Middlebury · Middlebury, INFrequently 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 1114363835. It was assigned to this organization in the NPPES registry on May 21, 2013. The provider is doing business as Beacon Medical Group Middlebury.
Where is Beacon Medical Group, Inc. located?
Beacon Medical Group, Inc. is located at 206 W Warren St, Middlebury, IN 46540. The listed phone number is (574) 825-2146.
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, 3 practice at this address and 8 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Beacon Medical Group, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 15D0356768) is associated with this NPI, valid through June 19, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
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 March 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Beacon Medical Group Middlebury · NPI 1114363835
Family Medicine organization in Middlebury, Indiana. Organization record, active in the CMS NPPES registry since May 21, 2013.
## Identity
- **NPI:** 1114363835 (Entity type: Organization)
- **Enumerated:** May 21, 2013
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Beacon Medical Group, Inc.
- **Organization subpart:** No
- **Authorized official:** Jeffrey Costello, CFO
## Practice location
- **Address:** 206 W WARREN ST, Middlebury, IN 46540-9410
- **Phone:** (574) 825-2146 · **Fax:** (574) 524-7435
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 734 clinicians in 45 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (188), Family Practice (113), Certified Registered Nurse Anesthetist (CRNA) (49); 3 practice at this address and 8 within 10 miles; [full list](https://npiprofile.com/npi/1114363835/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 4, 2024
- **Other identifiers:** Medicaid 100114000G (IN)
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1114363835) · Data from the CMS NPPES public registry.