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BEACON MEDICAL GROUP GOSHEN
NPI 1689691297
Family Medicine in Goshen, IN

Active since July 17, 2006CLIA 15D0955447 · Microscopy
2120 RIETH BLVD STE C, GOSHEN, IN 46526(574) 875-6911(574) 875-1057 Get Directions Write a Review

NPPES record last updated: March 4, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 4, 2024, Oct 27, 2016, Sep 21, 2016 (3 updates tracked since 2016).

About Beacon Medical Group Goshen NPPES

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

BEACON MEDICAL GROUP GOSHEN (NPI 1689691297) is a healthcare organization registered as a family medicine in Goshen, Indiana and active in the NPI registry since July 2006. The organization holds a CLIA Microscopy certificate valid through September 5, 2026 and lists Jeffrey P Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1689691297
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address2120 RIETH BLVD STE CGoshen, IN 46526-5858
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610 · Fax (574) 237-6069
Phone(574) 875-6911
Fax(574) 875-1057
Organization SubpartNo
Authorized OfficialJeffrey P CostelloCfo · (574) 647-3549
Enumeration DateJuly 17, 2006
Last NPPES UpdateMarch 4, 20243 updates tracked since enumeration
NPPES CertifiedMarch 4, 2024
✔ NPI 1689691297 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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 ListedNurse Practitioner · FamilyTaxonomy 363LF0000X
2120 RIETH BLVD STE C, Goshen, IN 46526
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Other Names 1

Doing Business AsBeacon Medical Group Goshen

Other Identifiers 2

Other000000110757IN · Anthem Bcbs
Medicaid200263280AIN

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 ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 15D0955447

Beacon Medical Group - Goshen · Goshen, IN
Active · expires Sep 5, 2026
CLIA Number15D0955447
Laboratory TypePhysician Office
Certificate Effective DateSeptember 6, 2024
Certificate Expiration DateSeptember 5, 2026
Laboratory DirectorZachary Dubois
Laboratory Phone(574) 875-6911
Laboratory LocationBeacon Medical Group - Goshen2120 Rieth Blvd Ste 300, Goshen, IN 46526
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

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

SAM JOSEPH BORRELLI M.D.
Family Medicine
2120 RIETH BLVD STE C
GOSHEN, IN 46526
Elkhart County (574) 875-6911
ZACHARY H DUBOIS DO
Family Medicine
2120 RIETH BLVD STE C
GOSHEN, IN 46526
Elkhart County (574) 875-6911
KIMBERLEE LYNN ACTON FNP-C
Nurse Practitioner (Family)
2120 RIETH BLVD STE C
GOSHEN, IN 46526
Elkhart County (574) 875-6911
FERNANDO S. ESCOVAR M.D.
Family Medicine
2120 RIETH BLVD STE C
GOSHEN, IN 46526
Elkhart County (574) 875-6911

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 1689691297. It was assigned to this organization in the NPPES registry on July 17, 2006. The provider is doing business as Beacon Medical Group Goshen.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 2120 Rieth Blvd Ste C, Goshen, IN 46526. The listed phone number is (574) 875-6911.

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

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

Does Beacon Medical Group, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 15D0955447) is associated with this NPI, valid through September 5, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and Anthem Blue Cross and Blue Shield 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 March 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.