BEACON MEDICAL GROUP, INC.
NPI 1295087500
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Elkhart, IN
- Organization
- Otolaryngology
- Otolaryngology/Facial Plastic Surgery
- Accepts Insurance
- CLIA Number: 15D2057229
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-10-2027
About BEACON MEDICAL GROUP, INC.
This page provides the complete NPI Profile along with additional information for Beacon Medical Group, Inc., a provider established in Elkhart, Indiana operating as a Otolaryngology, focusing in otolaryngology/facial plastic surgery . The healthcare provider is registered in the NPI registry with number 1295087500 assigned on October 2012. The practitioner's primary taxonomy code is 207YX0905X. The provider is registered as an organization and their NPI record was last updated 9 years ago. Beacon Medical Group, Inc. operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mr. Jeffrey P Costello (Cfo)
- NPI
- 1295087500 Verify this NPI
- Provider Name
- BEACON MEDICAL GROUP, INC.
- Entity Type
- Organization
- Location Address
- 1753 FULTON ST ELKHART, IN 46514
- Location Phone
- (574) 293-9448
- Location Fax
- (574) 293-9480
- Mailing Address
- 710 N NILES AVE SOUTH BEND, IN 46617
- Mailing Phone
- (574) 647-1610
- Mailing Fax
- (574) 237-6069
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-10-2012
- Last Update Date
- 10-12-2017
- Code Navigator
Location Map
Secondary Locations
- 1753 Fulton St
Elkhart, IN 46514
(574) 293-9448
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Otolaryngology Otolaryngology/Facial Plastic Surgery
- Taxonomy Code
- 207YX0905X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Y00000X | Allopathic & Osteopathic Physicians | Otolaryngology | |
| 2 | 231H00000X | Speech, Language and Hearing Service Providers | Audiologist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Gold - HMO
- Clear Gold + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Standard Gold - HMO
- Standard Gold + Vision + Adult Dental - HMO
- Standard Silver - HMO
- Standard Silver + Vision + Adult Dental - HMO
- Anthem Bronze Essential 10150 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 10150 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential 6500 HSA (+ Incentives) - HMO
- Anthem Bronze Essential 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Bronze Essential POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Essential POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Catastrophic Essential (+ Incentives) - HMO
- Anthem Gold Essential 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Gold Essential 2200 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Anthem Heart Healthy Bronze Essential 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 262950 | MEDICARE PIN (08) | IN |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 15D2057229
- Facility Type
- Physician Office
- Certificate Effective Date
- April 11, 2025
- Certificate Expiration Date
- April 10, 2027
- Laboratory Director
- ANDREA L. GENTILE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Beacon Medical Group, Inc. to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for BEACON MEDICAL GROUP, INC.
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Other Providers at the Same Location
The following 8 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295087500, enumerated as an "organization" on October 10, 2012.
The provider is located at 1753 FULTON ST ELKHART, IN 46514 and the phone number is (574) 293-9448.
Otolaryngology with taxonomy code 207YX0905X and a focus in Otolaryngology/Facial Plastic Surgery.
The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.
