BEACON MEDICAL GROUP, INC. (NPI# 1053864868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053864868 |
| Entity Type | Organization |
| Organization Name | BEACON MEDICAL GROUP, INC. |
| Other Organization Name | BEACON PHYSICAL THERAPY |
| Practice Address |
3221 Beacon Parkway Suite B Granger IN 46530 |
| Mailing Address |
710 N Niles Ave South Bend IN 46617-1924 |
| Practice Telephone | 5746471700 |
| Practice Fax Number | 5742913351 |
| Mailing Telephone | 5746471610 |
| Mailing Fax Number | 5742376069 |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2016-07-28 |
| Authorized Official Name | JEFFREY P COSTELLO (CFO) |
| Authorized Official Telephone | 5746473549 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Beacon Physical Therapy | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487038360 | Beacon Medical Group, Inc. | Radiology | 233 Florence Ave, Granger, IN 46530-8048 | 2015-07-10 |
| 1124423546 | Beacon Medical Group, Inc. | Internal Medicine | 100 Navarre Pl Ste 4400, South Bend, IN 46601-1100 | 2014-10-28 |
| 1487061131 | Beacon Medical Group, Inc. | Internal Medicine | 2400 N Ventura Way, Lagrange, IN 46761-4101 | 2014-07-15 |
| 1437574530 | Beacon Medical Group, Inc. | Otolaryngology | 711 S Health Pkwy Ste 1, Medical Office Building #1, Three Rivers, MI 49093-8354 | 2014-02-26 |
| 1528362647 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave., Suite 400, Elkhart, IN 46514 | 2011-01-04 |
| 1699794057 | Beacon Medical Group, Inc. | Internal Medicine | 500 Arcade Ave Ste 300, Elkhart, IN 46514-2486 | 2006-07-18 |
| 1205852365 | Beacon Medical Group, Inc. | Family Medicine | 27082 W. Main Street, Edwardsburg, MI 49112-9334 | 2006-07-14 |
| 1861421141 | Beacon Medical Group, Inc. | Psychiatry & Neurology | 100 Navarre Pl Ste 6600, South Bend, IN 46601 | 2006-06-30 |
| 1467408237 | Beacon Medical Group, Inc. | Pediatrics | 615 N Michigan St Fl 5, South Bend, IN 46601 | 2006-05-25 |
| 1275587149 | Beacon Medical Group, Inc. | Family Medicine | 813 S Michigan St, South Bend, IN 46601 | 2006-05-22 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | BEACON MEDICAL GROUP, INC. | 4601 Glendale Court, Savage, MN 55378-2543 |
| Street Address |
3221 BEACON PARKWAY SUITE B |
| City | GRANGER |
| State | IN |
| Zip Code | 46530 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538300561 | Michael Robert Messmer | Family Medicine | 3221 Beacon Parkway, Granger, IN 46530 | 2009-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821610783 | Michiana Weight Loss and Wellness Clinic LLC | Internal Medicine | 14304 Sr 23, Granger, IN 46530 | 2020-05-14 |
| 1609427921 | Stephen J Armet | Physical Therapist | 16733 Saratoga Ct, Granger, IN 46530 | 2019-09-27 |
| 1881177756 | Memorial Hospital of South Bend | General Acute Care Hospital | 3220 Beacon Parkway, Granger, IN 46530 | 2018-09-07 |
| 1922483635 | Kiley Ramer | Behavioral Analyst | 6910 N Main St Bldg 13c51, Granger, IN 46530 | 2015-07-23 |
| 1326439415 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 625 E University Dr., Granger, IN 46530 | 2015-02-10 |
| 1811302094 | Costco Wholesale Corporation | Pharmacy | 625 E. University Drive, Granger, IN 46530 | 2014-06-25 |
| 1255773255 | Tracy Joyce Abel | Behavioral Analyst | 12042 Covered Wagon Court, Granger, IN 46530 | 2013-07-19 |
| 1225376304 | George Youssef | Internal Medicine | 5610 Town Center Drive #14, Granger, IN 46530 | 2013-01-23 |
| 1033489596 | Rene Raul Arce Guarnaluse | Homeopath | Emilio Bayarri 50, Puzol, VALENCIA 46530 | 2011-12-30 |
| 1568747368 | Ranya Bouzou-kadi | Pharmacist | 13060 Adams, Granger, IN 46530 | 2011-10-13 |
| Find all providers in zip 46530 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588286132 | Amanda Lynn Ponce De Leon | Physical Therapist | 12171 Covered Wagon Ct, Granger, IN 46530-7100 | 2020-05-16 |
| 1528699196 | Kandace Cheri' Habenicht | Physical Therapist | 52183 Woodsedge Dr, Granger, IN 46530-8270 | 2020-01-31 |
| 1942830971 | Benjamin Matthew Burkett | Physical Therapist | 13932 Lexington Cir S, Granger, IN 46530-4969 | 2020-01-17 |
| 1609427921 | Stephen J Armet | Physical Therapist | 16733 Saratoga Ct, Granger, IN 46530 | 2019-09-27 |
| 1336530757 | Abner Mantoo | Physical Therapist | 51238 Kendallwood Dr, Granger, IN 46530-4705 | 2015-02-06 |
| 1720319742 | Maria Dolores Santos Menzen | Physical Therapist | 13723 Ravenwood Dr, Granger, IN 46530-4724 | 2010-01-15 |
| 1366771479 | Michiana Therapy Network | Physical Therapist | 51738 Sagecrest Dr, Granger, IN 46530-6887 | 2009-12-18 |
| 1760622815 | Abc Therapy Services, LLC | Physical Therapist | 12655 State Road 23, Granger, IN 46530-9641 | 2009-03-03 |
| 1659581569 | Bobbie Bates Seng | Physical Therapist | 16147 Darden Rd, Granger, IN 46530-9509 | 2007-05-22 |
| 1700907235 | Abc Therapy Services, LLC | Physical Therapist | 50920 Cherry Farm Trl, Granger, IN 46530-8942 | 2007-04-03 |
| Find all providers in GRANGER | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.