BEACON MEDICAL GROUP, INC.
NPI 1639196249
Family Medicine in Elkhart, IN

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

The NPI number for Beacon Medical Group, Inc. is 1639196249. It was assigned to this organization in the NPPES registry on July 17, 2006. The provider is doing business as Beacon Medical Group-Elkhart East.

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

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since July 17, 2006

3301 COUNTY ROAD 6 E, ELKHART, IN 46514(574) 264-9635(574) 262-0398 Get Directions Write a Review

NPPES record last updated: February 5, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 5, 2025, Sep 21, 2016 (2 updates tracked since 2016).

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About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1639196249), doing business as Beacon Medical Group-elkhart East, is a healthcare organization registered as a family medicine in Elkhart, Indiana and active in the NPI registry since July 2006. The organization lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1639196249

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameBEACON MEDICAL GROUP, INC.

Location Address3301 COUNTY ROAD 6 EElkhart, IN 46514-7673

Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-1610 · Fax (574) 237-6069

Phone(574) 264-9635

Fax(574) 262-0398

Organization SubpartNo

Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549

Enumeration DateJuly 17, 2006

Last NPPES UpdateFebruary 5, 20252 updates tracked since enumeration

NPPES CertifiedFebruary 5, 2025

✔ NPI 1639196249 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 6

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · NephrologyTaxonomy 207RN0300X

Also ListedOrthopaedic SurgeryTaxonomy 207X00000X

Also ListedPodiatrist · Foot & Ankle SurgeryTaxonomy 213ES0103X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

3301 COUNTY ROAD 6 E, Elkhart, IN 46514

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Other Names 1

Doing Business AsBeacon Medical Group-elkhart East

Other Identifiers 2

Medicaid100114000AIN

OtherANTHEM BCBSIN · 000000110759

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 and more.Insurance ›

Other Providers at the Same Location NPPES 14

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

MR. KENNETH FRANCIS RADERSTORF III NP

Nurse Practitioner (Family)