Beacon Medical Group Cardiothoracic Surgery South Bend

LBN: Beacon Medical Group, Inc.
Beacon Medical Group Cardiothoracic Surgery South Bend is an health care organization with primary practice located at 610 N Michigan St Ste 306 , South Bend IN 46601-1079. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) is the primary health care specialty. Beacon Medical Group, Inc. can be contacted via phone (574) 647-6500, or through Costello, Jeffrey P via phone (574) 647-3549.

Contact Information

Primary practice address
610 N Michigan St Ste 306 South Bend IN 46601-1079
Phone: (574) 647-6500
Fax: (574) 647-6518
Website:
Map and Directions
Authorized official contact:
Name: Costello, Jeffrey P
Phone: (574) 647-3549

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1881971505
LBN Legal business name Beacon Medical Group, Inc.
DBA Doing business as Beacon Medical Group Cardiothoracic Surgery South Bend
Authorized official Costello, Jeffrey P
Entity Organization
Organization subpart 1 No
Enumeration date Nov 9th, 2011
Last updated Feb 22nd, 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 1881971505 NPPES
Indiana MEDICAID 201041690A

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