Song I Baek, in Elkhart, IN - Medicare Nurse Practitioner

Song I Baek, is a medicare enrolled "Nurse Practitioner - Family" in Elkhart, Indiana. She went to University Of Michigan Medical School and graduated in 2016 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Cleanslate Medical Group Of Indiana Llc and her current practice location is 1004 Parkway Ave Ste E, Elkhart, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 218-7131.

Song I Baek is licensed to practice in Indiana (license number 71006583A) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679020119.

Contact Information

	Song I Baek,
	1004 Parkway Ave Ste E, Elkhart, IN 46516-9349
	(574) 218-7131
	Not Available

Map and Direction

Provider's Profile

Full Name	Song I Baek
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	1004 Parkway Ave Ste E, Elkhart, Indiana
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Song I Baek attended and graduated from University Of Michigan Medical School in 2016

NPI Data:

NPI Number: 1679020119
Provider Enumeration Date: 09/01/2016
Last Update Date: 09/24/2025

Medicare PECOS Information:

PECOS PAC ID: 2163701160
Enrollment ID: I20161115001906

Medical Identifiers

Medical identifiers for Song I Baek such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679020119	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	71006583A (Indiana)	Primary
363LF0000X	Nurse Practitioner - Family	28231893A (Indiana)	Secondary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Cleanslate Medical Group Of Indiana Llc	4880963909	47

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Song I Baek allows following entities to bill medicare on her behalf.

Entity Name	Heart City Health Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720033418 PECOS PAC ID: 9931008380 Enrollment ID: O20040105000515

Entity Name	Cleanslate Medical Group Of Indiana Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023464294 PECOS PAC ID: 4880963909 Enrollment ID: O20171023001515

Entity Name	Informe Healthcare Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407343965 PECOS PAC ID: 8123375474 Enrollment ID: O20180723000258

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Song I Baek is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Song I Baek, 1004 Parkway Ave Ste E, Elkhart, IN 46516-9349 Ph: (574) 218-7131	Song I Baek, 1004 Parkway Ave Ste E, Elkhart, IN 46516-9349 Ph: (574) 218-7131

Reviews and Comments

Nurse Practitioner Nurses in Elkhart, IN

Elizabeth W Maina, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052
Ms. Cecilia Mumbi Maina, FNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052
Mr. Kenneth Francis Raderstorf Iii, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3301 County Road 6 E, Elkhart, IN 46514 Phone: 574-266-5342 Fax: 574-266-5847
Rosemary J Eash, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1627 E Bristol St, Elkhart, IN 46514 Phone: 574-262-0313 Fax: 574-262-8163
Lorraine Doris Swartzentruber, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 236 Simpson Ave, Elkhart, IN 46516 Phone: 574-293-0052
Ashley Marie Brunt, NURSE PRA Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 500 Arcade Ave Ste 400, Elkhart, IN 46514 Phone: 574-522-2284 Fax: 574-522-3952
Mrs. Catherine E Dos Santos, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3421 S Main St, Elkhart, IN 46517 Phone: 574-295-7178 Fax: 574-295-8822

Song I Baek, - Medicare Nurse Practitioner in Elkhart, IN