Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Beacon Medical Group, Inc

Organization Family Medicine Physician · NPI 1568413359

Beacon Medical Group, Inc provides Family Medicine Physician services in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2006.

Licensed in
IN
In the registry since
2006
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

See every abbreviation used in this directory →

Practice location Address checks out

3575 Portage Ave
South Bend, IN 46628-6092 Not confirmed with CMS for 13 years — call before visiting
Phone: (574) 647-4530
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 01054535A (IN)

Record details

NPI number1568413359
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp-Cfo · (574) 647-3549
Other names Beacon Medical Group Portage Road
NPI enumeratedMay 15, 2006
Last updated in NPPESSeptember 27, 2013
Mailing address53842 Generations Dr, South Bend, IN 46635-1543

Other providers in South Bend