BEACON MEDICAL GROUP INC. NPI 1528362647

NPI Information

NPI: 1528362647
Provider Name: BEACON MEDICAL GROUP, INC.

Doing Business As: BEACON MEDICAL GROUP ADVANCED CARDIOVASCULAR SPECIALISTS RIVERPOINTE

Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
500 ARCADE AVE STE 400
ELKHART, IN
ZIP 46514
Phone: (574) 522-2284
Get Directions

BEACON MEDICAL GROUP, INC. is a cardiovascular disease internal medicine in Elkhart, IN. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. BEACON MEDICAL GROUP, INC. NPI is 1528362647. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Beacon Medical Group Advanced Cardiovascular Specialists Riverpointe.

The provider's business location address is:

500 ARCADE AVE STE 400
ELKHART, IN
ZIP 46514-487
Phone: (574) 522-2284
Fax: (574) 522-3952

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

The enumeration date for this NPI number is 1/4/2011 and was last updated on 2/22/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	11-005017-1	INDIANA	No
2	207RI0011X	Internal Medicine	Interventional Cardiology	11-005017-1	INDIANA	No
3	363A00000X	Physician Assistant				No
4	363LF0000X	Nurse Practitioner	Family			No
5	207RC0000X	Internal Medicine	Cardiovascular Disease	11-005017-1	INDIANA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	201004850B	MEDICAID	INDIANA

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: 5/5/2024

NPI Synchronization or Removal

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