Beacon Medical Group LaPorte – Family Medicine Physician, NPI 1639129117

Beacon Medical Group LaPorte is a healthcare provider. based in South bend, Indiana. specializing in Family Medicine Physician. The organization holds a License No. 01056419A (IN). The NPI Number for Beacon Medical Group LaPorte is 1639129117

Main info

Organization
Name
Beacon Medical Group LaPorte
NPI
1639129117
Phone
(574) 647-1610
Address
710 N NILES AVE
Authorized Official
JEFFREY COSTELLO VP-CFO
Enumeration Date
12 May 2006
Last Update Date
4 March 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 LaPorte

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

    SOUTH BEND, IN 466171924

    Phone: (574) 647-1610

    Type: Mailing

  • 900, I Street, La Porte, LaPorte County, Indiana, 46350, United States

    LA PORTE, IN 463505533

    Phone: (219) 324-1700

    Fax: (219) 324-1710

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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

How is Beacon Medical Group LaPorte identified in CMS data?
CMS-hosted NPPES data lists Beacon Medical Group LaPorte with NPI 1639129117.
Does the file indicate Beacon Medical Group LaPorte is practicing under active NPI?
Directory data currently reports Beacon Medical Group LaPorte as active.
What is Beacon Medical Group LaPorte's primary classification?
Family Medicine Physician is the headline specialty for Beacon Medical Group LaPorte here. Clinical services aligned with this taxonomy classification.
Does Beacon Medical Group LaPorte list a practice location?
Patients near South Bend, Indiana may find Beacon Medical Group LaPorte in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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