BEACON MEDICAL GROUP SPORTS MEDICINE SOUTH BEND
NPI 1578515151
Family Medicine - Sports Medicine in South Bend, IN

Q: What is Beacon Medical Group, Inc.'s NPI number?

The NPI number for Beacon Medical Group, Inc. is 1578515151. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Beacon Medical Group Sports Medicine South Bend.

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

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

Active since May 16, 2006

111 W JEFFERSON BLVD, SUITE 100, SOUTH BEND, IN 46601(574) 647-1669(574) 239-6461 Get Directions Write a Review

NPPES record last updated: August 30, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

On this page

About Beacon Medical Group Sports Medicine South Bend NPPES

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

BEACON MEDICAL GROUP SPORTS MEDICINE SOUTH BEND (NPI 1578515151) is a healthcare organization registered as a sports 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

NPI1578515151

Entity TypeOrganization

Primary Taxonomy207QS0010X

Legal Business NameBEACON MEDICAL GROUP, INC.

Location Address111 W JEFFERSON BLVD, SUITE 100South Bend, IN 46601-1994

Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610

Phone(574) 647-1669

Fax(574) 239-6461

Organization SubpartNo

Authorized OfficialJeffrey CostelloVp-cfo · (574) 647-3549

Enumeration DateMay 16, 2006

Last NPPES UpdateAugust 30, 2016

✔ NPI 1578515151 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily Medicine · Sports MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QS0010X

License✔ Licensed in IN · 01049328A

Definition

A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.

111 W JEFFERSON BLVD, South Bend, IN 46601

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Other Names 1

Doing Business AsBeacon Medical Group Sports Medicine South Bend

Other Identifiers 2

Medicaid200302560AIN

Medicare PIN233530IN

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

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 Sports Medicine South Bend 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 Sports Medicine South Bend, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 365 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

Heather Saffel, MD

Sports Medicine

NPI 1700231313

111 W JEFFERSON BLVD STE 100
South Bend, IN 46601

(574) 647-1670

✔ PECOS✔ Accepts MedicareSame address

Cody Ward, MD

Family Practice

NPI 1316501257

111 W JEFFERSON BLVD STE 100
South Bend, IN 46601

(574) 647-1670

✔ PECOS✔ Accepts MedicareSame address

Linda Mansfield, MD

Sports Medicine

NPI 1629075957

111 W JEFFERSON BLVD STE 100
South Bend, IN 46601

(574) 647-1669

✔ PECOS✔ Accepts Medicare0.1 mi

Laura Fessler, MSN, CCRN, AGACNP-BC

Nurse Practitioner

NPI 1194203851

610 N MICHIGAN ST STE 400
South Bend, IN 46601

(574) 647-8120

✔ PECOS✔ Accepts Medicare0.3 mi

Scott Hurley, M.D.

Internal Medicine

NPI 1326380247

610 N MICHIGAN ST STE 400
South Bend, IN 46601

(574) 647-8120

✔ PECOS✔ Accepts Medicare0.3 mi

Stacey Johnston, MD

Family Practice

NPI 1144414368

615 N MICHIGAN ST FL 1
South Bend, IN 46601

(574) 647-3050

✔ PECOS✔ Accepts Medicare0.4 mi

David Chi, MD

Hospitalist

NPI 1932662780

615 N MICHIGAN ST FL 1
South Bend, IN 46601

(574) 647-3050

✔ PECOS✔ Accepts Medicare0.4 mi

David Hornback, MD

Radiation Oncology

NPI 1790770964

615 N MICHIGAN ST
South Bend, IN 46601

(574) 647-1100

✔ PECOS✔ Accepts Medicare0.4 mi

Jonathan Ji, M.D.

Neurology

NPI 1477603504

615 N MICHIGAN ST FL 1
South Bend, IN 46601

(574) 647-1610

✔ PECOS✔ Accepts Medicare0.4 mi

James Jin, M.D.

Medical Oncology

NPI 1215900311

615 N MICHIGAN ST
South Bend, IN 46601

(574) 647-1100

✔ PECOS✔ Accepts Medicare0.4 mi

Nonyem Onujiogu, MD

Gynecological Oncology

NPI 1124262522

615 N MICHIGAN ST
South Bend, IN 46601

(574) 647-1100

✔ PECOS✔ Accepts Medicare0.4 mi

Muhammad Aslam, MD

Interventional Cardiology

NPI 1023053022

610 N MICHIGAN ST STE 400
South Bend, IN 46601

(574) 647-8120

✔ PECOS✔ Accepts Medicare0.5 mi

Vinod Chauhan, MD

Cardiovascular Disease (Cardiology)

NPI 1831196641

610 N MICHIGAN ST STE 400
South Bend, IN 46601

(574) 647-8120

✔ PECOS0.5 mi

Daniel Weber, M.D.

Thoracic Surgery

NPI 1942520762

610 N MICHIGAN ST STE 306
South Bend, IN 46601

(574) 647-6500

✔ PECOS✔ Accepts Medicare0.5 mi

Richard Skupski, M.D.

Anesthesiology

NPI 1396722989

416 E MONROE ST SUITE 200
South Bend, IN 46601

(574) 232-8119

✔ PECOS✔ Accepts Medicare0.5 mi

Jagadeesh Reddy, M.D.

Psychiatry

NPI 1275705691

707 N MICHIGAN ST STE 400
South Bend, IN 46601

(574) 647-8470

✔ PECOS✔ Accepts Medicare0.5 mi

Asad Ansari, MD

Pediatric Medicine

NPI 1053387175

100 NAVARRE PL STE 5550
South Bend, IN 46601

(574) 647-2550

✔ PECOS✔ Accepts Medicare0.5 mi

Andrew Berkson, DO

Physical Medicine and Rehabilitation

NPI 1255304010

100 NAVARRE PL STE 6600
South Bend, IN 46601

(574) 647-8800

✔ PECOS✔ Accepts Medicare0.5 mi

Margaret Dhom, SLP

Qualified Speech Language Pathologist

NPI 1467817791

100 NAVARRE PL STE 4460
South Bend, IN 46601

(574) 235-1010

✔ Accepts Medicare0.5 mi

Willie Donald, M.D.

Obstetrics/Gynecology

NPI 1225026669

100 NAVARRE PL STE 4410
South Bend, IN 46601

(574) 647-1650

✔ PECOS✔ Accepts Medicare0.5 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.

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 1578515151. It was assigned to this organization in the NPPES registry on May 16, 2006. The provider is doing business as Beacon Medical Group Sports Medicine South Bend.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 111 W Jefferson Blvd Suite 100, South Bend, IN 46601. The listed phone number is (574) 647-1669.

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

The primary specialty registered for this NPI is Family Medicine, specializing in Sports Medicine, with taxonomy code 207QS0010X.

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, 2 practice at this address and 365 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 August 30, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.