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BEACON MEDICAL GROUP, INC.
NPI 1861816761
Pediatrics in Elkhart, IN

Active since February 12, 2014CLIA 15D2019223 · Waiver
1627 E BRISTOL ST, ELKHART, IN 46514(574) 262-0313(574) 262-8163 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 12, 2025, Aug 14, 2018, Aug 30, 2016 (3 updates tracked since 2016).

About Beacon Medical Group, Inc. NPPES

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

BEACON MEDICAL GROUP, INC. (NPI 1861816761), doing business as Beacon Medical Group Pediatrics Bristol Street, is a healthcare organization registered as a pediatrics in Elkhart, Indiana and active in the NPI registry since February 2014. The organization holds a CLIA Waiver certificate valid through July 6, 2028, maintains 2 additional practice locations, and lists Jeffrey P. Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1861816761
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address1627 E BRISTOL STElkhart, IN 46514-3817
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (574) 647-3725
Phone(574) 262-0313
Fax(574) 262-8163
Organization SubpartNo
Authorized OfficialJeffrey P. CostelloCfo · (574) 647-3549
Enumeration DateFebruary 12, 2014
Last NPPES UpdateAugust 12, 20253 updates tracked since enumeration
NPPES CertifiedAugust 12, 2025
✔ NPI 1861816761 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1627 E BRISTOL ST, Elkhart, IN 46514
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Other Names 3

Doing Business AsBeacon Medical Group Pediatrics Bristol Street
Doing Business AsBeacon Medical Group Pediatrics Goshen
Doing Business AsBeacon Medical Group Pediatrics Rieth Blvd

Secondary Practice Locations 2

Location 12120 Rieth Blvd Ste 200Goshen, IN 46526-5867 · Phone (574) 262-0313 · Fax (574) 262-8163
Location 22606 Peddlers Village Rd Ste 218Goshen, IN 46526-1004 · Phone (574) 262-0313 · Fax (574) 262-8163

Other Identifiers 3

Medicaid100114000HIN
Medicaid100114000IIN
Medicaid300114876IN

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 of Waiver 15D2019223

Beacon Medical Group Pediatrics Goshen · Goshen, IN
Active · expires Jul 6, 2028
CLIA Number15D2019223
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2026
Certificate Expiration DateJuly 6, 2028
Laboratory DirectorDr. Andrew G. Lapadat
Laboratory Phone(574) 262-0313
Laboratory LocationBeacon Medical Group Pediatrics Goshen2606 Peddlers Village Rd, Ste 218, Goshen, IN 46526
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

ROSEMARY J EASH FNP
Nurse Practitioner (Family)
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
MR. JORDAN ALLEN HUNSBERGER DO
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
DR. SHAHIR OKHOVAT-GHAHFAROKHI M.D.
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
DR. ANDREA BETH BONTRAGER YODER PHD, RDN, CD
Dietitian, Registered
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
DR. SU CHOO CHANG MD
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
BRISTOL STREET PEDIATRICS, P.C.
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
SANDRA H. MORGAN M.D.
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313
EMILY MARIE KISOR M.D.
Pediatrics
1627 E BRISTOL ST
ELKHART, IN 46514
Elkhart County (574) 262-0313

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 1861816761. It was assigned to this organization in the NPPES registry on February 12, 2014. The provider is doing business as Beacon Medical Group Pediatrics Bristol Street, Beacon Medical Group Pediatrics Goshen and Beacon Medical Group Pediatrics Rieth Blvd.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 1627 E Bristol St, Elkhart, IN 46514. The listed phone number is (574) 262-0313.

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

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

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

Yes. A Certificate of Waiver (number 15D2019223) is associated with this NPI, valid through July 6, 2028. 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 August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.