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 1972831311

Beacon Medical Group, Inc provides Cardiovascular Disease Physician services in Plymouth, Indiana. Licensed in Indiana. Registered with an NPI since 2009.

Licensed in
IN
In the registry since
2009
Specialties on file
2
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

2855 Miller Dr Ste 121
Plymouth, IN 46563-8091 Not confirmed with CMS for 10 years — call before visiting
Phone: (574) 647-1600
Fax: (574) 237-6069
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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)
Rheumatology Physician Taxonomy 207RR0500X · Licence 01061323A (IN)

Record details

NPI number1972831311
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jeffrey Costello — Vp/Cfo · (574) 647-3549
Other names Beacon Medical Group Specialists Plymouth
NPI enumeratedNovember 23, 2009
Last updated in NPPESAugust 30, 2016
Mailing address710 N Niles Ave, South Bend, IN 46617-1924

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