BEACON MEDICAL GROUP INC. NPI 1699794057

NPI Information

  • NPI: 1699794057
  • Provider Name: BEACON MEDICAL GROUP, INC.
  • Classification: Internal Medicine - 207RG0100X
  • Specialization: Gastroenterology
  • Entity Type: Organization
  • :
  • Address: 500 ARCADE AVE STE 300
    ELKHART, IN
    ZIP 46514
  • Phone: (574) 389-7362

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NPI Details

BEACON MEDICAL GROUP, INC. is a gastroenterology internal medicine in Elkhart, IN. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. BEACON MEDICAL GROUP, INC. NPI is 1699794057. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

500 ARCADE AVE STE 300
ELKHART, IN
ZIP 46514-486
Phone: (574) 389-7362
Fax: (574) 389-5612

The provider's authorized official is Jeffrey P Costello .
The authorized official title is Cfo and has the following contact phone number (574) 647-3549.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 6/13/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12085R0204XRadiologyVascular & Interventional RadiologyNo
2208800000XUrologyNo
3207RG0100XInternal MedicineGastroenterology06-005017-1INDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1300054801MEDICAIDINDIANA
2300042826MEDICAIDINDIANA
3300098369MEDICAIDINDIANA
4300098524MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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