BEACON MEDICAL GROUP WAKARUSA
NPI 1184641706
Family Medicine in Wakarusa, IN

Active since July 17, 2006CLIA 15D2232582 · Waiver
207 N ELKHART ST, WAKARUSA, IN 46573(574) 862-2165(574) 862-4112 Get Directions Write a Review

NPPES record last updated: March 4, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 4, 2024, Oct 27, 2016, Sep 21, 2016 (3 updates tracked since 2016).

About Beacon Medical Group Wakarusa NPPES

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

BEACON MEDICAL GROUP WAKARUSA (NPI 1184641706) is a healthcare organization registered as a family medicine in Wakarusa, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through August 15, 2027 and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184641706
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address207 N ELKHART STWakarusa, IN 46573-9729
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Fax(574) 862-4112
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJuly 17, 2006
Last NPPES UpdateMarch 4, 20243 updates tracked since enumeration
NPPES CertifiedMarch 4, 2024
✔ NPI 1184641706 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
207 N ELKHART ST, Wakarusa, IN 46573

Other Names 1

Doing Business AsBeacon Medical Group Wakarusa

Other Identifiers 2

OtherANTHEM BCBSIN · 000000110760
Medicaid200019030AIN

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 Wakarusa 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 Wakarusa, which bills Medicare for the services they deliver. Of these, 42 practice 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
Family Practice
NPI 1184367864
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.1 mi
Family Practice
NPI 1609850908
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.1 mi
Nurse Practitioner
NPI 1003655572
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.1 mi
Nurse Practitioner
NPI 1912103151
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Family Practice
NPI 1255330924
2102 N. MAIN STREET
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Family Practice
NPI 1417958976
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Nurse Practitioner
NPI 1164893616
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Family Practice
NPI 1346249364
2102 N MAIN ST
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Nurse Practitioner
NPI 1932447760
2102 N. MAIN STREET
Nappanee, IN 46550
(574) 862-2165
✔ PECOS✔ Accepts Medicare5.4 mi
Family Practice
NPI 1114028743
2120 RIETH BLVD STE C
Goshen, IN 46526
(574) 875-6911
✔ PECOS✔ Accepts Medicare8.6 mi
Nurse Practitioner
NPI 1053042762
2222 RIETH BLVD STE 100
Goshen, IN 46526
(574) 875-1200
✔ PECOS✔ Accepts Medicare8.7 mi
Rheumatology
NPI 1841712999
2222 RIETH BLVD STE 104
Goshen, IN 46526
(574) 389-5540
✔ PECOS✔ Accepts Medicare8.8 mi
Pediatric Medicine
NPI 1841281748
2606 PEDDLERS VILLAGE RD STE 218
Goshen, IN 46526
(574) 262-0313
✔ PECOS✔ Accepts Medicare8.9 mi
Obstetrics/Gynecology
NPI 1194764449
1144 W PLYMOUTH ST
Bremen, IN 46506
(574) 546-5363
✔ PECOS9.4 mi
Neurology
NPI 1336352806
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts Medicare9.8 mi
Psychiatry
NPI 1760987275
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 256-9032
✔ PECOS✔ Accepts Medicare9.8 mi
Clinical Social Worker
NPI 1629899877
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts Medicare9.8 mi
Neurology
NPI 1720439680
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts Medicare9.8 mi
Neurology
NPI 1992167746
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts Medicare9.8 mi
Physical Medicine and Rehabilitation
NPI 1932488665
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 256-9032
✔ PECOS✔ Accepts Medicare9.9 mi
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.

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 15D2232582

Beacon Medical Group Wanee · Nappanee, IN
Active · expires Aug 15, 2027
CLIA Number15D2232582
Laboratory TypePhysician Office
Certificate Effective DateAugust 16, 2025
Certificate Expiration DateAugust 15, 2027
Laboratory DirectorEric J. Miller
Laboratory Phone(574) 862-2165
Laboratory LocationBeacon Medical Group Wanee2102 North Main Street, Nappanee, IN 46550
CLIA data matches this NPI record on: Name Phone
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 1184641706. It was assigned to this organization in the NPPES registry on July 17, 2006. The provider is doing business as Beacon Medical Group Wakarusa.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 207 N Elkhart St, Wakarusa, IN 46573. The listed phone number is (574) 862-2165.

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, 42 practice 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 15D2232582) is associated with this NPI, valid through August 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

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 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.