Beacon Medical Group, Inc.
NPI 1033161617ActiveOrganization· Family Medicine· Mishawaka, IN
Family Medicine in Mishawaka, Indiana, registered in NPPES in May 2006. The authorized official on file is Jeffrey Costello, Vp-Cfo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1033161617 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 16, 2006 |
| Last updated in NPPES | Feb 13, 2025 |
| Certified by provider | Feb 13, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | 01058339A | IN |
| Internal Medicine, Cardiovascular Disease | 207RC0000X | — | — |
| Internal Medicine, Interventional Cardiology | 207RI0011X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IN) |
|---|
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