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

NPI Status: Active since May 16, 2006

Contact Information

111 W JEFFERSON BLVD
SUITE 100
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-1669
Fax: (574) 239-6461

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  • Organization
  • Family Medicine
  • Sports Medicine
  • Accepts Insurance

About BEACON MEDICAL GROUP SPORTS MEDICINE SOUTH BEND

This page provides the complete NPI Profile along with additional information for Beacon Medical Group Sports Medicine South Bend, a primary care provider established in South Bend, Indiana operating as a Family Medicine, focusing in sports medicine . The healthcare provider is registered in the NPI registry with number 1578515151 assigned on May 2006. The practitioner's primary taxonomy code is 207QS0010X with license number 01049328A (IN). The provider is registered as an organization and their NPI record was last updated 10 years ago. Beacon Medical Group Sports Medicine South Bend operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Beacon Medical Group Sports Medicine South Bend. The authorized official of this NPI record is Jeffrey Costello (Vp-cfo)

NPI
1578515151
Provider Legal Name
BEACON MEDICAL GROUP, INC.
Other Organization Name
BEACON MEDICAL GROUP SPORTS MEDICINE SOUTH BEND
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
111 W JEFFERSON BLVD SUITE 100 SOUTH BEND, IN 46601
Location Phone
(574) 647-1669
Location Fax
(574) 239-6461
Mailing Address
710 N NILES AVE SOUTH BEND, IN 46617
Mailing Phone
(574) 647-1610
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-16-2006
Last Update Date
08-30-2016
Code Navigator

A primary care provider (PCP) like Beacon Medical Group Sports Medicine South Bend sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Sports Medicine

Taxonomy Code
207QS0010X
Type
Allopathic & Osteopathic Physicians
License No.
01049328A
License State
IN
Taxonomy Description
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.

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Clear Gold - HMO
  • Clear Gold + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Clear Silver - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Gold - HMO
  • Everyday Gold + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Focused Silver - HMO
  • Focused Silver + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

JEFFREY COSTELLO

Authorized Official Title
VP-CFO
Authorized Official Phone
(574) 647-3549

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
200302560AMEDICAID (05)IN 
233530MEDICARE PIN (08)IN 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1578515151, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 49. The final step is to find the difference between that total and the next multiple of ten (50 - 49 = 1).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
8
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
1
Unchanged
Pos 7
5
Doubled → 10 → 1 + 0
Pos 8
1
Unchanged
Pos 9
5
Doubled → 10 → 1 + 0
Check
1
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 5 → 10 → 1 5 → 10 → 1

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 4 + 8 + 1 + 0 + 1 + 1 + 0 + 1 + 1 + 0 + 24 = 49

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 49 is 50. The difference is the calculated check digit.

50 - 49 = 1
This NPI is valid
The calculated check digit is 1, which matches the last digit of 1578515151.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, STE. 100
SOUTH BEND, IN 46601
Social Worker (Clinical)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Acupuncturist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
Family Medicine (Sports Medicine)
111 W JEFFERSON BLVD, STE 100
SOUTH BEND, IN 46601
Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Physical Therapist (Orthopedic)
111 W JEFFERSON BLVD
SOUTH BEND, IN 46601
Specialist/Technologist (Athletic Trainer)
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601
Specialist
111 W JEFFERSON BLVD, SUITE 100
SOUTH BEND, IN 46601

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1578515151, enumerated as an "organization" on May 16, 2006.

The provider is located at 111 W JEFFERSON BLVD SUITE 100 SOUTH BEND, IN 46601 and the phone number is (574) 647-1669.

Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.

The provider might be accepting Accepts: Ambetter from Buckeye Health Plan, Ambetter from. Please consult your insurance carrier or call the provider to verify.