Beacon Medical Group Neurosurgery Mishawaka

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Neurosurgery Mishawaka is an health care organization with primary practice located at 100 Navarre Pl Ste 6600 , South Bend IN 46601-1173. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurological Surgery, Allopathic & Osteopathic Physicians / Neurology, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Allopathic & Osteopathic Physicians / Neurological Surgery is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-8800, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
100 Navarre Pl Ste 6600 South Bend IN 46601-1173
Phone: (574) 647-8800
Fax: (574) 647-8811
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X
Allopathic & Osteopathic Physicians / Neurology 2084N0400X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X

Profile Details

NPI number 1861421141
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Neurosurgery Mishawaka
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Jun 30th, 2006
Last updated Jul 10th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861421141 NPPES
Indiana MEDICAID 201003280A
Indiana MEDICAID 201003280C
Indiana MEDICAID 300041458
Indiana MEDICAID 201003280B

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