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BEACON MEDICAL GROUP, INC.
NPI 1275550899
Family Medicine in Mishawaka, IN

Active since July 17, 2006CLIA 15D2281931 · Waiver
5314 LINCOLNWAY E, MISHAWAKA, IN 46544(574) 584-2812(574) 584-2813 Get Directions Write a Review

NPPES record last updated: March 18, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 18, 2026, Feb 4, 2026, Mar 4, 2024 and 5 more (8 updates tracked since 2016).

About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1275550899), doing business as Beacon Medical Group Mishawaka, is a healthcare organization registered as a family medicine in Mishawaka, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through May 14, 2027, maintains a secondary practice location in Mishawaka, and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1275550899
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address5314 LINCOLNWAY EMishawaka, IN 46544-4249
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-2129
Phone(574) 584-2812
Fax(574) 584-2813
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJuly 17, 2006
Last NPPES UpdateMarch 18, 20268 updates tracked since enumeration
NPPES CertifiedMarch 18, 2026
✔ NPI 1275550899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 8

★ 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 ListedSocial Worker · ClinicalTaxonomy 1041C0700X
Also ListedInternal Medicine · Cardiovascular DiseaseTaxonomy 207RC0000X
Also ListedInternal Medicine · Interventional CardiologyTaxonomy 207RI0011X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
Also ListedNurse Practitioner · Women's HealthTaxonomy 363LW0102X
Also ListedAdvanced Practice MidwifeTaxonomy 367A00000X
5314 LINCOLNWAY E, Mishawaka, IN 46544
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Other Names 1

Doing Business AsBeacon Medical Group Mishawaka

Secondary Practice Location 1

Location 1202 Lincolnway E Ste 201Mishawaka, IN 46544-2079 · Phone (574) 584-2812 · Fax (574) 584-2813

Other Identifiers 1

Medicaid300127345IN

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 ›

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, Inc. 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, Inc., which bills Medicare for the services they deliver. Of these, 10 practice at this address and 489 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
Kiesha Anderson, D.O.
Neurology
NPI 1720439680
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts MedicareSame address
Nadia Bowling, M.D
Neurology
NPI 1992167746
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts MedicareSame address
Amy Brown, NP
Nurse Practitioner
NPI 1013686625
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Jessica Evans, NP
Nurse Practitioner
NPI 1851865174
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Johnny Gerardot, MD
Family Practice
NPI 1336673037
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Cara Johnson, NP
Nurse Practitioner
NPI 1083502652
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Nicholas Pechin, DO
Psychiatry
NPI 1760987275
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 256-9032
✔ PECOS✔ Accepts MedicareSame address
Nicole Rose
Nurse Practitioner
NPI 1922697572
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Ryan Stoy, LCSW
Clinical Social Worker
NPI 1629899877
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 584-2812
✔ PECOS✔ Accepts MedicareSame address
Abhishek Das, M.D.
Physical Medicine and Rehabilitation
NPI 1932488665
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 256-9032
✔ PECOS✔ Accepts MedicareSame address
Jose Lopez, M.D.
Neurology
NPI 1336352806
5314 LINCOLNWAY E
Mishawaka, IN 46544
(574) 647-8542
✔ PECOS✔ Accepts Medicare0.1 mi
Daniel Abel, M.D.
Family Practice
NPI 1508177619
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Ryan Bonek, M.D.
Family Practice
NPI 1730523846
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Jennifer Pennington, D.O.
Family Practice
NPI 1114145687
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Aroba Sadaf, DO
Family Practice
NPI 1689193211
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Jamie Thacker
Nurse Practitioner
NPI 1548998131
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Joseph Caruso, M.D.
Family Practice
NPI 1598763203
4630 VISTULA RD
Mishawaka, IN 46544
(574) 647-1900
✔ PECOS✔ Accepts Medicare0.5 mi
Brian Huber, MD
Family Practice
NPI 1538322805
1710 E DAY RD
Mishawaka, IN 46545
(574) 213-2514
✔ PECOS✔ Accepts Medicare3.9 mi
John Gilbert, D.O.
Otolaryngology
NPI 1275735581
810 PARK PLACE
Mishawaka, IN 46545
(574) 366-0240
✔ PECOS✔ Accepts Medicare4.3 mi
Loren Calderone, NP-C
Nurse Practitioner
NPI 1437763299
710 PARK PL
Mishawaka, IN 46545
(574) 273-6776
✔ PECOS✔ Accepts Medicare4.4 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 15D2281931

Beacon Medical Group · Mishawaka, IN
Active · expires May 14, 2027
CLIA Number15D2281931
Laboratory TypePhysician Office
Certificate Effective DateMay 15, 2025
Certificate Expiration DateMay 14, 2027
Laboratory DirectorJohnny Gerardot
Laboratory Phone(574) 584-2812
Laboratory LocationBeacon Medical Group202 Lincolnway E, Ste 201, Mishawaka, IN 46544
CLIA data matches this NPI record on: Address 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 1275550899. It was assigned to this organization in the NPPES registry on July 17, 2006. The provider is doing business as Beacon Medical Group Mishawaka.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 5314 Lincolnway E, Mishawaka, IN 46544. The listed phone number is (574) 584-2812.

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, 10 practice at this address and 489 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 15D2281931) is associated with this NPI, valid through May 14, 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 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 March 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months 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.