Provider Type Icon

BEACON MEDICAL GROUP INC. NPI 1861421141


NPI Information

NPI: 1861421141
Provider Name: BEACON MEDICAL GROUP, INC.

Doing Business As: BEACON MEDICAL GROUP NEUROSURGERY MISHAWAKA

Classification: Neurological Surgery - 207T00000X
Entity Type: Organization
Address:
100 NAVARRE PL STE 6600
SOUTH BEND, IN
ZIP 46601
Phone: (574) 647-8800
Get Directions

BEACON MEDICAL GROUP, INC. is a neurological surgery in South Bend, IN. The provider is a neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. BEACON MEDICAL GROUP, INC. NPI is 1861421141. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Beacon Medical Group Neurosurgery Mishawaka.

The provider's business location address is:

100 NAVARRE PL STE 6600
SOUTH BEND, IN
ZIP 46601-173
Phone: (574) 647-8800
Fax: (574) 647-8811

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

The enumeration date for this NPI number is 6/30/2006 and was last updated on 3/4/2024.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207T00000XNeurological SurgeryYes
22084N0400XPsychiatry & NeurologyNeurologyNo

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1201003280CMEDICAIDINDIANA
2201003280BMEDICAIDINDIANA
3201003280AMEDICAIDINDIANA
4300041458MEDICAIDINDIANA

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: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.