BEACON MEDICAL GROUP, INC.
NPI 1295087500
Otolaryngology - Otolaryngology/Facial Plastic Surgery in Elkhart, IN

Active since October 10, 2012CLIA 15D2057229 · Waiver
1753 FULTON ST, ELKHART, IN 46514(574) 293-9448(574) 293-9480 Get Directions Write a Review

NPPES record last updated: October 12, 2017. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1295087500) is a healthcare organization registered as an otolaryngology/facial plastic surgery in Elkhart, Indiana and active in the NPI registry since October 2012. The organization holds a CLIA Waiver certificate valid through April 10, 2027, maintains a secondary practice location in Elkhart, and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1295087500
Entity TypeOrganization
Primary Taxonomy207YX0905X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address1753 FULTON STElkhart, IN 46514-1927
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Fax(574) 293-9480
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateOctober 10, 2012
Last NPPES UpdateOctober 12, 2017
✔ NPI 1295087500 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOtolaryngology · Otolaryngology/Facial Plastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207YX0905X
Definition
An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions.
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedAudiologistTaxonomy 231H00000X
1753 FULTON ST, Elkhart, IN 46514

Secondary Practice Location 1

Location 11753 Fulton StElkhart, IN 46514-1927 · Phone (574) 293-9448 · Fax (574) 293-9480

Other Identifiers 1

Medicare PIN262950IN

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, 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, 5 practice at this address and 202 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
Otolaryngology
NPI 1942664784
1753 FULTON ST
Elkhart, IN 46514
(574) 293-9448
✔ PECOS✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1861919888
1753 FULTON ST
Elkhart, IN 46514
(574) 293-9448
✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1881440022
1753 FULTON ST
Elkhart, IN 46514
(574) 293-9448
✔ Accepts MedicareSame address
Qualified Audiologist
NPI 1871332353
1753 FULTON ST
Elkhart, IN 46514
(574) 293-9448
✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1174298764
1753 FULTON ST
Elkhart, IN 46514
(574) 293-9448
✔ PECOS✔ Accepts MedicareSame address
Cardiovascular Disease (Cardiology)
NPI 1164425997
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3466
✔ PECOS✔ Accepts Medicare0.1 mi
Interventional Cardiology
NPI 1609076777
303 S NAPPANEE ST STE A
Elkhart, IN 46514
(574) 296-3338
✔ PECOS✔ Accepts Medicare0.1 mi
Nurse Practitioner
NPI 1144953902
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3200
✔ PECOS✔ Accepts Medicare0.1 mi
Obstetrics/Gynecology
NPI 1417956756
2405 WEST LEXINGTON AVENUE
Elkhart, IN 46514
(574) 524-7575
✔ PECOS✔ Accepts Medicare0.4 mi
Pulmonary Disease
NPI 1528061447
303 S NAPPANEE ST
Elkhart, IN 46514
(574) 296-3314
✔ PECOS✔ Accepts Medicare0.4 mi
Certified Nurse Midwife (CNM)
NPI 1104222165
2405 W LEXINGTON AVE
Elkhart, IN 46514
(574) 524-7575
✔ PECOS0.4 mi
Pain Management
NPI 1447711866
500 ARCADE AVE STE 200
Elkhart, IN 46514
(574) 294-8404
✔ PECOS✔ Accepts Medicare0.6 mi
General Surgery
NPI 1043893225
500 ARCADE AVE STE 320
Elkhart, IN 46514
(574) 523-7900
✔ PECOS0.6 mi
Gastroenterology
NPI 1447253539
500 ARCADE AVE STE 300
Elkhart, IN 46514
(574) 389-7362
✔ PECOS✔ Accepts Medicare0.6 mi
Anesthesiology
NPI 1831180306
500 ARCADE AVE STE 210
Elkhart, IN 46514
(574) 389-5656
✔ PECOS✔ Accepts Medicare0.6 mi
Thoracic Surgery
NPI 1053486191
500 ARCADE AVE STE 230
Elkhart, IN 46514
(574) 522-6565
✔ PECOS✔ Accepts Medicare0.6 mi
Critical Care (Intensivists)
NPI 1427344761
500 ARCADE AVE STE 210
Elkhart, IN 46514
(574) 389-5656
✔ PECOS✔ Accepts Medicare0.6 mi
Cardiac Electrophysiology
NPI 1326042102
500 ARCADE AVE STE 400
Elkhart, IN 46514
(574) 522-2284
✔ PECOS✔ Accepts Medicare0.6 mi
Neurosurgery
NPI 1629073853
500 ARCADE AVE STE 200
Elkhart, IN 46514
(574) 232-7227
✔ PECOS✔ Accepts Medicare0.6 mi
Family Practice
NPI 1871592865
3301 COUNTY ROAD 6 E
Elkhart, IN 46514
(574) 264-9635
✔ PECOS✔ Accepts Medicare0.6 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 15D2057229

Beacon Medical Group Ent And Audiology Elkhart · Elkhart, IN
Active · expires Apr 10, 2027
CLIA Number15D2057229
Laboratory TypePhysician Office
Certificate Effective DateApril 11, 2025
Certificate Expiration DateApril 10, 2027
Laboratory DirectorAndrea L. Gentile
Laboratory Phone(574) 293-9448
Laboratory LocationBeacon Medical Group Ent And Audiology Elkhart1753 Fulton St, Elkhart, IN 46514
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 1295087500. It was assigned to this organization in the NPPES registry on October 10, 2012.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 1753 Fulton St, Elkhart, IN 46514. The listed phone number is (574) 293-9448.

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

The primary specialty registered for this NPI is Otolaryngology, specializing in Otolaryngology/Facial Plastic Surgery, with taxonomy code 207YX0905X.

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, 5 practice at this address and 202 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 15D2057229) is associated with this NPI, valid through April 10, 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 and 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 October 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.