Beacon Medical Group, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BEACON MEDICAL GROUP, INC.

Doing business as

Beacon Medical Group Bittersweet Commons

Practice address

12340 Bittersweet Commons Blvd W
Granger, IN 46530-6959

Phone

(574) 271-8610

Fax

(574) 271-8620

NPI assigned

Jun 2, 2009

Last updated

Apr 24, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeffrey P Costello

Title

Cfo

Phone

(574) 647-3549

Specialties & licenses 1

Addresses

Other names 1

• Beacon Medical Group Bittersweet Commons Doing business as

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nazmul Huda, MD

  • Interventional Cardiology Physician
  • Elkhart, IN
  • NPI 1609076777
  NPD
• Shelley A. Morris, D.O.

  • Family Medicine Physician
  • Granger, IN
  • NPI 1376737387
  NPD
• Mary-Kate Oatman, MSN, RN, FNP

  • Family Nurse Practitioner
  • Mishawaka, IN
  • NPI 1326310160
  NPD
• Mark P Schmeltz, DO

  • Family Medicine Physician
  • Granger, IN
  • NPI 1487653408
  NPD
• Tammy Gene Slott, FNP-BC

  • Family Nurse Practitioner
  • Elkhart, IN
  • NPI 1114265204
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1003042318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N NILES AVE",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466171924",
            "telephone_number": "574-647-1610",
            "fax_number": "574-237-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12340 BITTERSWEET COMMONS BLVD W",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465306959",
            "telephone_number": "574-271-8610",
            "fax_number": "574-271-8620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-02",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-647-3549",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Medical Group Bittersweet Commons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Beacon Medical Group Bittersweet Commons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Douglas Craig Bateman, D.D.S.
• David S Battle
• Jane E Beachy, S.L.P.
• Beacon Health, LLC (Beacon Physical Therapy)
• Beacon Health, LLC
• Beacon Medical Group, Inc. (Beacon Medical Group Main Street)
• Beacon Medical Group, Inc. (Beacon Physical Therapy)
• Beacon Medical Group, Inc. (Beacon Medical Group Specialists Main Suite 100)
• Beacon Medical Group, Inc. (Beacon Medical Group Vein Specialists)
• Beacon Medical Group, Inc. (MedPoint Urgent Care)

• Family Medicine Physician in Granger, IN
• Providers in Granger, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.