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BEACON MEDICAL GROUP VASCULAR INTERVENTIONAL RADIOLOGY
NPI 1932468352
Radiology - Vascular & Interventional Radiology in South Bend, IN

Active since May 04, 2012
621 MEMORIAL DR STE 312, SOUTH BEND, IN 46601(574) 647-5200(574) 647-5210 Get Directions Write a Review

NPPES record last updated: October 12, 2017. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Beacon Medical Group Vascular Interventional Radiology NPPES

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

BEACON MEDICAL GROUP VASCULAR INTERVENTIONAL RADIOLOGY (NPI 1932468352) is a healthcare organization registered as a vascular & interventional radiology in South Bend, Indiana and active in the NPI registry since May 2012. The organization lists Jeffrey P. Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1932468352
Entity TypeOrganization
Primary Taxonomy2085R0204X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address621 MEMORIAL DR STE 312South Bend, IN 46601-1073
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Phone(574) 647-5200
Fax(574) 647-5210
Organization SubpartNo
Authorized OfficialJeffrey P. CostelloCfo · (574) 647-3549
Enumeration DateMay 4, 2012
Last NPPES UpdateOctober 12, 2017
✔ NPI 1932468352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Vascular & Interventional RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0204X
Definition
A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging.
621 MEMORIAL DR STE 312, South Bend, IN 46601
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Other Names 1

Doing Business AsBeacon Medical Group Vascular Interventional Radiology

Other Identifiers 2

Medicare PINM100069308IN
Medicaid201063130AIN

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 Anthem Blue Cross and Blue Shield.Insurance ›

Other Providers at the Same Location NPPES 2

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

STACY L MC DOWELL CNS
Clinical Nurse Specialist
621 MEMORIAL DR STE 312
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5200
KEVIN M SMALL MD
Radiology (Vascular & Interventional Radiology)
621 MEMORIAL DR STE 312
SOUTH BEND, IN 46601
St. Joseph County (574) 647-5200

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 1932468352. It was assigned to this organization in the NPPES registry on May 4, 2012. The provider is doing business as Beacon Medical Group Vascular Interventional Radiology.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 621 Memorial Dr Ste 312, South Bend, IN 46601. The listed phone number is (574) 647-5200.

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

The primary specialty registered for this NPI is Radiology, specializing in Vascular & Interventional Radiology, with taxonomy code 2085R0204X.

What insurance does Beacon Medical Group, Inc. accept?

Health plans from 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 October 12, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.