CMS-1500 Box 24J / 33a • NPI
1821222829
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207RC0200X (CMS 11)
Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)
Box 32 Service Location & ZIP+4
500 ARCADE AVE STE 320, ELKHART, IN, 46514-2477
✓ 9-Digit EDI 837 ZIP+4 (46514-2477)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1821222829 (BEACON MEDICAL GROUP, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1821222829 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BEACON MEDICAL GROUP, INC. |
| Plain-English Specialty | Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) NUCC Code: 207RC0200X (Internal Medicine, Critical Care Medicine) |
| Certifying / Licensing Body | American Board of Internal Medicine (ABIM) |
| Practice Location Address | 500 ARCADE AVE STE 320, ELKHART, IN, 46514-2477 |
| Practice Telephone / Fax | Tel: (574) 523-7900 |
| Administrative Mailing Address | 3245 HEALTH DR STE 100, GRANGER, IN, 46530-1380 |
| Enumeration & Last Sync | Enumerated: 2009-05-06 | CMS Record Updated: 2026-03-31 |
| Authorized Official | JEFFREY COSTELLO (VP/CFO) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207RC0200X)
What Does Taxonomy Code 207RC0200X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207RC0200X translates to:
"Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BEACON MEDICAL GROUP, INC.)
Typical CPT / Diagnostic Procedures:- Complex Multi-System Adult Diagnostic Workup (CPT 99204–99215)
- Preoperative Medical Risk Assessment & Cardiac Clearance
- Chronic Kidney, Hepatic & Metabolic Panel Interpretation
- Adult Inpatient Hospitalist Management & Discharge Coordination
- Antihypertensives (ACE Inhibitors, ARBs, Calcium Channel Blockers, Thiazides)
- Oral Antidiabetic Agents, Basal/Bolus Insulins & Lipid-Lowering Statins
- Direct Oral Anticoagulants (Apixaban, Rivaroxaban) & Antiplatelets
- Levothyroxine (Hypothyroidism) & Proton Pump Inhibitors (Pantoprazole)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
2086S0129X — Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Surgery — Vascular Surgery | State: N/A | License: Verified | Primary: Secondary |
208M00000X — HospitalistPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Hospitalist | State: IN | License: 01049858A | Primary: Secondary |
207RI0200X — Internal Medicine, Infectious DiseasePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207RG0100X — Internal Medicine, GastroenterologyPlain English: Board-Certified Gastroenterologist (Digestive Tract & Liver Specialist) | State: N/A | License: Verified | Primary: Secondary |
2084N0400X — Psychiatry & Neurology, NeurologyPlain English: Board-Certified Neurologist (Brain, Spine, Stroke & Nerve Specialist) | State: N/A | License: Verified | Primary: Secondary |
207X00000X — Orthopaedic SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: IN | License: 01049858A | Primary: Secondary |
208600000X — SurgeryPlain English: Board-Certified Orthopedic Surgeon (Bone, Joint, Spine & Sports Injury Surgeon) | State: N/A | License: Verified | Primary: Secondary |
207R00000X — Internal MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
207RC0000X — Internal Medicine, Cardiovascular DiseasePlain English: Board-Certified Cardiologist (Heart & Blood Vessel Specialist) | State: N/A | License: Verified | Primary: Secondary |
207VG0400X — Obstetrics & Gynecology, GynecologyPlain English: Board-Certified Obstetrician & Gynecologist (Women's Health & Pregnancy Doctor) | State: N/A | License: Verified | Primary: Secondary |
207RP1001X — Internal Medicine, Pulmonary DiseasePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Secondary |
208100000X — Physical Medicine & RehabilitationPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Physical Medicine & Rehabilitation | State: N/A | License: Verified | Primary: Secondary |
207YX0905X — Otolaryngology, Otolaryngology/Facial Plastic SurgeryPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Otolaryngology — Otolaryngology — Facial Plastic Surgery | State: N/A | License: Verified | Primary: Secondary |
2085R0204X — Radiology, Vascular & Interventional RadiologyPlain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Radiology, Vascular and Interventional Radiology | State: N/A | License: Verified | Primary: Secondary |
207RC0200X — Internal Medicine, Critical Care MedicinePlain English: Board-Certified Internist (Adult Diagnostic & Chronic Disease Physician) | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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