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MEMORIAL PAIN MANAGEMENT
NPI 1518302264
Nurse Practitioner - Adult Health in South Bend, IN

Active since May 08, 2013
621 MEMORIAL DR, SUITE 602, SOUTH BEND, IN 46601(574) 647-7413(574) 647-2471 Get Directions Write a Review

NPPES record last updated: August 30, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Memorial Pain Management NPPES

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

MEMORIAL PAIN MANAGEMENT (NPI 1518302264) is a healthcare organization registered as an adult health in South Bend, Indiana and active in the NPI registry since May 2013. The organization lists Jeffrey P. Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1518302264
Entity TypeOrganization
Primary Taxonomy363LA2200X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address621 MEMORIAL DR, SUITE 602South Bend, IN 46601-1063
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Phone(574) 647-7413
Fax(574) 647-2471
Organization SubpartNo
Authorized OfficialJeffrey P. CostelloCfo · (574) 647-3549
Enumeration DateMay 8, 2013
Last NPPES UpdateAugust 30, 2016
✔ NPI 1518302264 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LA2200X
License✔ Licensed in IN · 71001587A
621 MEMORIAL DR, South Bend, IN 46601
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Other Names 1

Doing Business AsMemorial Pain Management

Other Identifiers 2

Medicaid201164630AIN
Medicare PIN261970IN

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JOHN L JENKINS M.D.
Specialist
621 MEMORIAL DR, STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 234-9001
SCOTT G THOMAS MD
Surgery
621 MEMORIAL DR, SUITE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875
EDWARD P DELLE DONNE MD
Colon & Rectal Surgery
621 MEMORIAL DR
SOUTH BEND, IN 46601
St. Joseph County (574) 236-1888
MEMORIAL HEALTH SYSTEM, INC.
Internal Medicine (Cardiovascular Disease)
621 MEMORIAL DR, SUITE 608
SOUTH BEND, IN 46601
St. Joseph County (574) 232-3522
DR. THOMAS R GRUSZYNSKI MD
Obstetrics & Gynecology
621 MEMORIAL DR, SUITE 616
SOUTH BEND, IN 46601
St. Joseph County (574) 234-2128
MICHAEL C ROTKIS MD
Surgery (Vascular Surgery)
621 MEMORIAL DR
SOUTH BEND, IN 46601
St. Joseph County (574) 236-1888
NORTH CENTRAL NEUROLOGY, LLC
Psychiatry & Neurology (Neurology)
621 MEMORIAL DR, SUITE 624
SOUTH BEND, IN 46601
St. Joseph County (574) 288-0215
WILLIAM ANDERSON MD
Surgery
621 MEMORIAL DR, STE 502
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5875

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 1518302264. It was assigned to this organization in the NPPES registry on May 8, 2013. The provider is doing business as Memorial Pain Management.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 621 Memorial Dr Suite 602, South Bend, IN 46601. The listed phone number is (574) 647-7413.

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

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

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 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.