Beacon Medical Group Ireland Road – Family Medicine Physician, NPI 1124079330

Beacon Medical Group Ireland Road is a healthcare provider. based in South bend, Indiana. specializing in Family Medicine Physician. The organization holds a License No. 01043622A (IN). The NPI Number for Beacon Medical Group Ireland Road is 1124079330

Main info

Organization
Name
Beacon Medical Group Ireland Road
NPI
1124079330
Phone
(574) 647-1610
Address
710 N NILES AVE
Authorized Official
JEFFREY COSTELLO VP-CFO
Enumeration Date
12 May 2006
Last Update Date
30 September 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness80
Years active:20State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Beacon Medical Group Ireland Road

  • 710, North Niles Avenue, South Bend, Saint Joseph County, Indiana, 46617, United States

    SOUTH BEND, IN 466171924

    Phone: (574) 647-1610

    Type: Mailing

  • 1815, East Ireland Road, South Bend, Saint Joseph County, Indiana, 46614, United States

    SOUTH BEND, IN 466142845

    Phone: (574) 647-1700

    Fax: (574) 291-3351

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46617)

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Reviews

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Frequently asked questions

What is the standard ID for Beacon Medical Group Ireland Road in the U.S.?
In the U.S., Beacon Medical Group Ireland Road is identified by NPI 1124079330.
Does the public listing show Beacon Medical Group Ireland Road as active?
Beacon Medical Group Ireland Road's NPI record reflects an active status in NPPES.
Which specialty label fits Beacon Medical Group Ireland Road?
NPPES ties Beacon Medical Group Ireland Road to Family Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Beacon Medical Group Ireland Road?
Beacon Medical Group Ireland Road is associated with South Bend, Indiana in the same public data insurers reference.
Who maintains Beacon Medical Group Ireland Road's record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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