1. Home
  2. Directory
  3. Indiana
  4. South Bend
  5. Pediatrics
  6. NPI Profile

BEACON MEDICAL GROUP PEDIATRIC HEMATOLOGY ONCOLOGY
NPI 1992756696
Pediatrics - Pediatric Hematology-Oncology in South Bend, IN

Active since May 15, 2006
615 N MICHIGAN ST 4TH FL, SOUTH BEND, IN 46601(574) 647-6892(574) 647-6895 Get Directions Write a Review

NPPES record last updated: March 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 4, 2024, Jul 3, 2018, Aug 30, 2016 (3 updates tracked since 2016).

About Beacon Medical Group Pediatric Hematology Oncology NPPES

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

BEACON MEDICAL GROUP PEDIATRIC HEMATOLOGY ONCOLOGY (NPI 1992756696) is a healthcare organization registered as a pediatric hematology-oncology in South Bend, Indiana and active in the NPI registry since May 2006. The organization lists Jeffrey Costello, Cfo, as its authorized official.

NPPES Registry Identity

NPI1992756696
Entity TypeOrganization
Primary Taxonomy2080P0207X
Legal Business NameBEACON MEDICAL GROUP, INC.
Location Address615 N MICHIGAN ST 4TH FLSouth Bend, IN 46601-1033
Mailing Address710 N Niles AveSouth Bend, IN 46617-1924 · (574) 647-1610
Phone(574) 647-6892
Fax(574) 647-6895
Organization SubpartNo
Authorized OfficialJeffrey CostelloCfo · (574) 647-3549
Enumeration DateMay 15, 2006
Last NPPES UpdateMarch 4, 20243 updates tracked since enumeration
NPPES CertifiedMarch 4, 2024
✔ NPI 1992756696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Hematology-OncologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0207X
License✔ Licensed in IN · 02001713A
Definition
A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases.
615 N MICHIGAN ST 4TH FL, South Bend, IN 46601
Open in Google Maps ↗

Other Names 1

Doing Business AsBeacon Medical Group Pediatric Hematology Oncology

Other Identifiers 1

Medicaid200510720AIN

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 3

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

BRIANA LONG
Nurse Practitioner (Family)
615 N MICHIGAN ST 4TH FL
SOUTH BEND, IN 46601
St. Joseph County (574) 647-6892
STACY L SNYDER MD
Pediatrics (Pediatric Hematology-Oncology)
615 N MICHIGAN ST 4TH FL
SOUTH BEND, IN 46601
St. Joseph County (574) 647-6892
ELAINE M. FAN MD
Pediatrics (Pediatric Hematology-Oncology)
615 N MICHIGAN ST 4TH FL
SOUTH BEND, IN 46601
St. Joseph County (574) 647-6892

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 1992756696. It was assigned to this organization in the NPPES registry on May 15, 2006. The provider is doing business as Beacon Medical Group Pediatric Hematology Oncology.

Where is Beacon Medical Group, Inc. located?

Beacon Medical Group, Inc. is located at 615 N Michigan St 4th Fl, South Bend, IN 46601. The listed phone number is (574) 647-6892.

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

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Hematology-Oncology, with taxonomy code 2080P0207X.

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.