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

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: August 16, 2026.

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health.Insurance ›

Other Providers at the Same Location NPPES 8

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

JENNIFER A BRAKE MD
Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, STE 100
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1669
MRS. KARA G WERNER-SANDERS LAT, ATC, CSCS
Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1670
DR. KEVIN JEREMY MCAWARD M.D.
Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, STE. 100
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1669
MRS. FREYA L BURKET A.C.S.W., L.C.S.W.
Social Worker (Clinical)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2624
PAUL ADAM ENRIGHT LIC. ACUP.
Acupuncturist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2600
KATELYN PATBERG LAT, ATC
Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
St. Joseph County (574) 647-1670
ANDREW JOHN FINDLEY
Physical Therapist (Orthopedic)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
St. Joseph County (574) 647-2509
JENNIFER ANN DYSZKIEWICZ MS, ATC, LAT
Specialist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
St. Joseph County (574) 289-4764

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.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan and Ambetter from Meridian 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 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.