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

Q: 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.

Q: 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.

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: August 02, 2026.

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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

Phone(574) 647-5875

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

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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

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 ›

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT G. CREDI MD

Surgery