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Contact Information

BEACON MEDICAL GROUP, INC.
100 NAVARRE PL STE 6600
SOUTH BEND, IN46601-1173
 Phone: 574-647-8800
 Fax: 574-647-8811
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neurological Surgery

207T00000X 02 Physician/General Surgery
 

Clinical Neurophysiology

2084N0600X 86 Physician/Neuropsychiatry
 

Family

363LF0000X 50 Nurse Practitioner
 

Neurology

2084N0400X 13 Physician/Neurology
 

Physician Assistant

363A00000X 97 Physician Assistant
 

Sleep Medicine

2084S0012X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for BEACON MEDICAL GROUP INC · (Female)

NPI Number 1861421141
Status Active
Credentials
Entity Individual
Enumeration date 06/30/2006
Last updated 03/30/2026 - About 2 months ago
Sole proprietor 1 Not specified
Identifiers
  • IN Medicaid 201003280A
  • IN Medicaid 201003280B
  • IN Medicaid 300041458
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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