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BEACON MEDICAL GROUP LAGRANGE SPECIALTY CLINIC
NPI 1487061131
Internal Medicine - Cardiovascular Disease in Lagrange, IN

Active since July 15, 2014
2400 N VENTURA WAY, LAGRANGE, IN 46761(574) 524-7123(574) 296-6522 Get Directions Write a Review

NPPES record last updated: August 30, 2016. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Beacon Medical Group Lagrange Specialty Clinic NPPES

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

BEACON MEDICAL GROUP LAGRANGE SPECIALTY CLINIC (NPI 1487061131) is a healthcare organization registered as a cardiovascular disease in Lagrange, Indiana and active in the NPI registry since July 2014. The organization lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1487061131
Entity TypeOrganization
Primary Taxonomy207RC0000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address2400 N VENTURA WAYLagrange, IN 46761-4101
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Phone(574) 524-7123
Fax(574) 296-6522
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJuly 15, 2014
Last NPPES UpdateAugust 30, 2016
✔ NPI 1487061131 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

2400 N VENTURA WAY, Lagrange, IN 46761
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Other Names 1

Doing Business AsBeacon Medical Group Lagrange Specialty Clinic

Other Identifiers 1

Medicare PIN236040IN

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

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 1487061131. It was assigned to this organization in the NPPES registry on July 15, 2014. The provider is doing business as Beacon Medical Group Lagrange Specialty Clinic.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 2400 N Ventura Way, Lagrange, IN 46761. The listed phone number is (574) 524-7123.

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

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Beacon Medical Group, Inc. was last updated on August 30, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.