Beacon Medical Group, Inc.
NPI 1629376645ActiveOrganization· Psychiatry & Neurology, Psychiatry· South Bend, IN
Psychiatry & Neurology, Psychiatry in South Bend, Indiana, registered in NPPES in March 2011. The authorized official on file is Jeffrey P. Costello, Vp/Cfo.
Overview
| NPI | 1629376645 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 1, 2011 |
| Last updated in NPPES | Feb 22, 2024 |
| Certified by provider | Feb 22, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychiatry & Neurology, Psychiatry Primary | 2084P0800X | 01052982A | IN |
| Family Medicine | 207Q00000X | — | — |
| Psychiatry & Neurology, Child & Adolescent Psychiatry | 2084P0804X | 01052982A | IN |
| Psychiatry & Neurology, Geriatric Psychiatry | 2084P0805X | 01052982A | IN |
| Nurse Practitioner, Psych/Mental Health | 363LP0808X | — | — |
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) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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