BEACON MEDICAL GROUP- TRAUMA AND SURGICAL SERVICES
NPI 1174927131
Surgery - Trauma Surgery in South Bend, IN

Active since October 20, 2014
621 MEMORIAL DR STE 502, SOUTH BEND, IN 46601(574) 647-5875(574) 647-5878 Get Directions Write a Review

NPPES record last updated: April 24, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Beacon Medical Group- Trauma And Surgical Services NPPES

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

BEACON MEDICAL GROUP- TRAUMA AND SURGICAL SERVICES (NPI 1174927131) is a healthcare organization registered as a trauma surgery in South Bend, Indiana and active in the NPI registry since October 2014. The organization lists Jeffrey P. Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1174927131
Entity TypeOrganization
Primary Taxonomy2086S0127X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address621 MEMORIAL DR STE 502South Bend, IN 46601-1075
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Fax(574) 647-5878
Organization SubpartNo
Authorized OfficialJeffrey P. CostelloCfo · (574) 647-3549
Enumeration DateOctober 20, 2014
Last NPPES UpdateApril 24, 2023
NPPES CertifiedApril 24, 2023
✔ NPI 1174927131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySurgery · Trauma SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0127X
Definition
Trauma surgery is a recognized subspecialty of general surgery. Trauma surgeons are physicians who have completed a five-year general surgery residency and usually continue with a one to two year fellowship in trauma and/or surgical critical care, typically leading to additional board certification in surgical critical care. There is no trauma surgery board certification at this point. To obtain board certification in surgical critical care, a fellowship in surgical critical care or anesthesiology critical care must be completed during or after general surgery residency.
Also ListedSurgeryTaxonomy 208600000X
Also ListedSurgery · Vascular SurgeryTaxonomy 2086S0129X
621 MEMORIAL DR STE 502, South Bend, IN 46601

Other Names 1

Doing Business AsBeacon Medical Group- Trauma And Surgical Services

Other Identifiers 1

Medicaid200921930EIN

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

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- Trauma And Surgical Services 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- Trauma And Surgical Services, which bills Medicare for the services they deliver. Of these, 95 practice at this address and 365 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
Nurse Practitioner
NPI 1265951578
621 MEMORIAL DR STE 512
South Bend, IN 46601
(574) 246-9350
✔ PECOS✔ Accepts MedicareSame address
Infectious Disease
NPI 1285072454
621 MEMORIAL DR STE 624
South Bend, IN 46601
(574) 647-8177
✔ PECOS✔ Accepts MedicareSame address
Infectious Disease
NPI 1346276995
621 MEMORIAL DR STE 402 MEMORIAL HOSPITAL
South Bend, IN 46601
(574) 647-2500
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1447721105
621 MEMORIAL DR STE 502
South Bend, IN 46601
(574) 647-5875
✔ PECOSSame address
Family Practice
NPI 1558623686
621 MEMORIAL DR STE 402
South Bend, IN 46601
(574) 400-4550
✔ PECOS✔ Accepts MedicareSame address
Diagnostic Radiology
NPI 1689669715
621 MEMORIAL DR STE 312
South Bend, IN 46601
(574) 647-5200
✔ PECOS✔ Accepts MedicareSame address
General Surgery
NPI 1033196126
621 MEMORIAL DR SUITE 502
South Bend, IN 46601
(574) 647-5875
✔ PECOS✔ Accepts MedicareSame address
Family Practice
NPI 1710962915
621 MEMORIAL DR STE 402
South Bend, IN 46601
(574) 400-4550
✔ PECOS✔ Accepts MedicareSame address
Obstetrics/Gynecology
NPI 1376516732
100 NAVARRE PL STE 4470
South Bend, IN 46601
(574) 647-1405
✔ PECOS✔ Accepts MedicareSame address
Neurosurgery
NPI 1134641038
100 NAVARRE PL STE 6600
South Bend, IN 46601
(574) 647-8800
✔ PECOS✔ Accepts MedicareSame address
Physical Medicine and Rehabilitation
NPI 1780098780
100 NAVARRE PL STE 4440
South Bend, IN 46601
(574) 647-5300
✔ PECOS✔ Accepts MedicareSame address
Neurology
NPI 1720016926
100 NAVARRE PL STE 4400
South Bend, IN 46601
(574) 647-2501
✔ PECOS✔ Accepts MedicareSame address
Pediatric Medicine
NPI 1881764579
100 NAVARRE PL STE 5570
South Bend, IN 46601
(574) 647-8610
✔ PECOS✔ Accepts MedicareSame address
Orthopedic Surgery
NPI 1942572797
100 NAVARRE PL STE 4440
South Bend, IN 46601
(574) 647-5300
✔ PECOS✔ Accepts MedicareSame address
Interventional Radiology
NPI 1295991081
100 NAVARRE PL STE 5500
South Bend, IN 46601
(574) 647-5200
✔ PECOS✔ Accepts MedicareSame address
Certified Nurse Midwife (CNM)
NPI 1003795121
100 NAVARRE PL STE 4470
South Bend, IN 46601
(574) 647-1405
✔ PECOSSame address
Otolaryngology
NPI 1487187894
100 NAVARRE PL STE 4460
South Bend, IN 46601
(574) 235-1010
✔ PECOS✔ Accepts MedicareSame address
Qualified Speech Language Pathologist
NPI 1467817791
100 NAVARRE PL STE 4460
South Bend, IN 46601
(574) 235-1010
✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1265766703
100 NAVARRE PL STE 4460
South Bend, IN 46601
(574) 235-1010
✔ Accepts MedicareSame address
Clinical Psychologist
NPI 1538470018
100 NAVARRE PL STE 5570
South Bend, IN 46601
(574) 647-8610
✔ 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 1174927131. It was assigned to this organization in the NPPES registry on October 20, 2014. The provider is doing business as Beacon Medical Group- Trauma And Surgical Services.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 621 Memorial Dr Ste 502, South Bend, IN 46601. The listed phone number is (574) 647-5875.

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

The primary specialty registered for this NPI is Surgery, specializing in Trauma Surgery, with taxonomy code 2086S0127X.

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, 95 practice at this address and 365 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 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.