BEACON MEDICAL GROUP PORTAGE ROAD
NPI 1568413359
Family Medicine in South Bend, IN
About Beacon Medical Group Portage Road NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BEACON MEDICAL GROUP PORTAGE ROAD (NPI 1568413359) is a healthcare organization registered as a family medicine in South Bend, Indiana and active in the NPI registry since May 2006. The organization lists Jeffrey Costello, Vp-cfo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 2
Group Practice 1
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 Portage Road is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
734Medicare enrollment records show 734 clinicians reassign Medicare billing to Beacon Medical Group Portage Road, which bills Medicare for the services they deliver. Of these, 350 practice within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 45
Nearest to this location (20)
See all 734Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1568413359. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Beacon Medical Group Portage Road.
Where is Beacon Medical Group, Inc. located?
Beacon Medical Group, Inc. is located at 3575 Portage Ave, South Bend, IN 46628. The listed phone number is (574) 647-4530.
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, 350 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Beacon Medical Group, Inc. was last updated on September 27, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Beacon Medical Group Portage Road · NPI 1568413359
Family Medicine organization in South Bend, Indiana. Organization record, active in the CMS NPPES registry since May 15, 2006.
## Identity
- **NPI:** 1568413359 (Entity type: Organization)
- **Enumerated:** May 15, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Legal business name:** Beacon Medical Group, Inc.
- **Organization subpart:** No
- **Authorized official:** Jeffrey Costello, VP-CFO
## Practice location
- **Address:** 3575 PORTAGE AVE, South Bend, IN 46628-6092
- **Phone:** (574) 647-4530
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 734 clinicians in 45 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (188), Family Practice (113), Certified Registered Nurse Anesthetist (CRNA) (49); 350 practice within 10 miles; [full list](https://npiprofile.com/npi/1568413359/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 27, 2013
- **Other identifiers:** Medicare PIN 247000 (IN); Medicaid 100092700B (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1568413359) · Data from the CMS NPPES public registry.