NPIMap

Organization Active NPI

Elkhart General Hospital, Inc.

  • General Acute Care Hospital
  • Elkhart, IN
National Provider Identifier
1477551489
Registry record updated Sep 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
05-005017-1 Issued in IN
Legal business name
ELKHART GENERAL HOSPITAL, INC.
Practice address
600 East Blvd
Elkhart, IN 46514-2483
Phone
(574) 523-3200
Fax
(574) 523-3492
NPI assigned
Jul 13, 2005
Last updated
Sep 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2026

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

Authorized official

Name
Mr. Jeffrey Costello
Title
Cfo
Phone
(574) 647-3460

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0001X
Psychiatric Hospital Unit 273R00000X
General Acute Care Hospital 282N00000X 05-005017-1 IN Primary

Addresses

Primary practice location

600 East Blvd
Elkhart, IN 46514-2483

Mailing address

600 East Blvd
Elkhart, IN 46514-2483
Phone (574) 294-2621

Other practice location 1

303 S Nappanee St Ste B
Elkhart, IN 46514-2066
Phone (574) 294-2621

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031213000004 IN Part B Supplier - Clinic/Group Practice 4688571169 Receives reassigned benefits from 2 practitioners
3 other NPIs on this enrollment
Practice locations: Elkhart, IN
O20071226000283 IN Part A Provider - Hospital 4688571169 Practice locations: Elkhart, IN

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477551489. Details of each certification follow.

Hospital certification: CCN 150018

Legal name
ELKHART GENERAL HOSPITAL INC
Doing business as
ELKHART GENERAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Mar 31, 2016
Beds
297
Ownership / control type
Local
Organization structure
CorporationNon-profit
Incorporated
Mar 29, 1909 in IN
Enrollment address
600 East Blvd
Elkhart, IN 46514-2483
Other Hospital Practice Location
Hospital subgroups
Acute care

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Elkhart General HospitalCCN 150018 · All quality measures
Overall star rating
4 of 5
Type
Acute Care Hospitals
Ownership
Government - Local
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Locations

1506 Osolo Rd
#A
Elkhart, IN 46514
Phone (574) 295-1131

225 E Jackson Blvd
Elkhart, IN 46516
Phone (574) 523-3100

229 W Marion St
Elkhart, IN 46516
Phone (574) 295-9146

303 S Nappanee St
Ste B
Elkhart, IN 46514
Phone (574) 294-2621

500 Arcade Ave
Ste 310
Elkhart, IN 46514
Phone (574) 524-7400

27082 Main St
Edwardsburg, MI 49112
Phone (269) 246-1375

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Kreg Gruber Individual Corporate OfficerCoo Feb 24, 2016
W-2 Managing EmployeeCeo Feb 24, 2016
Irene Maffetone Individual W-2 Managing EmployeeManager Feb 24, 2016
Beacon Health System Inc Organization, South Bend, IN Corporation Operational/Managerial Control Nov 23, 2011 100%
Jeffrey P Costello Individual Corporate OfficerCfo Mar 1, 2012
Carl Risk Individual Corporate OfficerPresident Sep 9, 2016 100%

Facilities with the same owner 21

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 21

Practitioners & affiliated clinicians

Practitioners 30

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.

View all 30

Affiliated clinicians 535

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 535

NPI Registry JSON

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790121600000",
    "number": "1477551489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-294-2621",
            "fax_number": "574-523-3492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 EAST BLVD",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465142483",
            "telephone_number": "574-523-3200",
            "fax_number": "574-523-3492"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 S Nappanee St Ste B",
            "address_purpose": "LOCATION",
            "city": "Elkhart",
            "state": "IN",
            "postal_code": "465142066",
            "country_code": "US",
            "telephone_number": "574-294-2621",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELKHART GENERAL HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-13",
        "last_updated": "2026-09-23",
        "certification_date": "2026-09-23",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "574-647-3460",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Radiation Oncology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "IN",
            "license": "05-005017-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkhart, IN

Sources for this page

Verify at the official NPI Registry.