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

Beacon Medical Group, Inc

Organization Cardiovascular Disease Physician · NPI 1780859157

Beacon Medical Group, Inc provides Cardiovascular Disease Physician services in South Bend, Indiana. Licensed in Indiana. Registered with an NPI since 2008.

Licensed in
IN
In the registry since
2008
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

610 N Michigan St Ste 400
South Bend, IN 46601-1081
Phone: (574) 647-8120
Fax: (574) 647-8111
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Cardiovascular Disease Physician (primary) Taxonomy 207RC0000X · Licence 01045628A (IN)

Record details

NPI number1780859157
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp/Cfo · (574) 647-3549
Other names Beacon Medical Group Advanced Cardiology Specialists South Bend; Beacon Medical Group Advanced Cardiology Specialists South Bend
NPI enumeratedApril 28, 2008
Last updated in NPPESApril 24, 2023
Certification dateApril 24, 2023
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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