NPIMap

Organization Active NPI

Beacon Allegan Inc

Doing business as Beacon Allegan

  • Certified Registered Nurse Anesthetist
  • Allegan, MI
National Provider Identifier
1932364700
Registry record updated Oct 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
BEACON ALLEGAN INC
Doing business as
Beacon Allegan
Practice address
555 Linn St
Allegan, MI 49010-1524
Phone
(269) 686-4051
Fax
(269) 686-4236
NPI assigned
Jul 22, 2008
Last updated
Oct 9, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2026

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

Authorized official

Name
Irene Maffetone
Title
Manager Contracting and Payor Relat
Phone
(574) 647-1040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X NU Primary

Addresses

Primary practice location

555 Linn St
Allegan, MI 49010-1524

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other identifiers 3

IdentifierTypeStateIssuer
430Z36149OtherMIBLUE CARE NETWORK
430Z36149OtherMIBCBSM
1932364700MedicaidMI

Other names 1

  • Beacon Allegan Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050718000938 MI Part B Supplier - Clinic/Group Practice 5092750356 Receives reassigned benefits from 4 practitioners
Practice locations: Allegan, MI

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Allegan General Hospital4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791504000000",
    "number": "1932364700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380",
            "fax_number": "574-647-1821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 LINN ST",
            "city": "ALLEGAN",
            "state": "MI",
            "postal_code": "490101524",
            "telephone_number": "269-686-4051",
            "fax_number": "269-686-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEACON ALLEGAN INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2026-10-09",
        "certification_date": "2026-10-09",
        "status": "A",
        "authorized_official_last_name": "MAFFETONE",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "MANAGER CONTRACTING AND PAYOR RELAT",
        "authorized_official_telephone_number": "574-647-1040"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "430Z36149",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "430Z36149",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932364700",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beacon Allegan",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Allegan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.