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JI SUN BAEK M.D.
NPI 1164816070
Anesthesiology in Vallejo, CA

Active since March 28, 2015PECOS Enrolled
975 SERENO DR, VALLEJO, CA 94589(707) 651-2011 Get Directions Write a Review

NPPES record last updated: January 30, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Ji Sun Baek M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JI SUN BAEK M.D. (NPI 1164816070) is an individual anesthesiology provider in Vallejo, California, licensed in California (147376) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164816070
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameJI SUN BAEKCredential: M.D.
Location Address975 SERENO DRVallejo, CA 94589-2441
Mailing Address975 Sereno DrVallejo, CA 94589-2441
Phone(707) 651-2011
Sole ProprietorNo
Enumeration DateMarch 28, 2015
Last NPPES UpdateJanuary 30, 2023
NPPES CertifiedJanuary 30, 2023
✔ NPI 1164816070 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in CA · 147376
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
975 SERENO DR, Vallejo, CA 94589
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ji Sun Baek M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Ji Sun Baek reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Permanente Medical Group Inc
Same address
Internal Medicine
975 SERENO DRIVE
Vallejo, CA 94589
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1336222397 (707) 651-1000
John Muir Trauma Physicians Billing Service
19 mi
Trauma Surgery
1601 YGNACIO VALLEY RD
Walnut Creek, CA 94598
  • Reassigned Medicare billing, California enrollment
  • 810 clinicians in this Medicare group
NPI 1962551861 (925) 947-5331
G2 Anesthesia PC
63 mi
Anesthesiology
15466 LOS GATOS BLVD STE 109-297
Los Gatos, CA 95032
  • Reassigned Medicare billing, California enrollment
  • 140 clinicians in this Medicare group
NPI 1487214698 (408) 354-2114

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERTA YIWUN WANG M.D.
Physical Medicine & Rehabilitation
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-5128
RIHONG ZHOU
Pharmacist
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-2072
EVAN HIRSCHBEIN
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 339-2074
MS. JEAN BROADNAX LCSW
Social Worker (Clinical)
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-4423
SEAN NISAM
Student in an Organized Health Care Education/Training Program
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-4071
LI M. TSANG MD
Anesthesiology
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
DONN R. ERICKSON MD
Family Medicine
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000
JOHN S. WOOD MD
Surgery
975 SERENO DR
VALLEJO, CA 94589
Napa County (707) 651-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ji Sun Baek's NPI number?

The NPI number for Ji Sun Baek is 1164816070. It was assigned to this individual provider in the NPPES registry on March 28, 2015.

Where is Ji Sun Baek located?

Ji Sun Baek practices at 975 Sereno Dr, Vallejo, CA 94589. The listed phone number is (707) 651-2011.

What is Ji Sun Baek's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Ji Sun Baek enrolled in Medicare?

Yes. Ji Sun Baek is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Ji Sun Baek's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ji Sun Baek reassigns Medicare benefits to 3 organizations: Permanente Medical Group Inc (Vallejo, CA), John Muir Trauma Physicians Billing Service (Walnut Creek, CA) and G2 Anesthesia PC (Los Gatos, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Ji Sun Baek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Ji Sun Baek was last updated on January 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.