SONG I BAEK
NPI 1679020119
Nurse Practitioner - Family in Elkhart, IN
About Song I Baek NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SONG I BAEK (NPI 1679020119) is an individual family provider in Elkhart, Indiana, licensed in Indiana (71006583A) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Song I Baek is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
3Medicare enrollment records show Song Baek reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Elkhart, IN 46516
- Reassigned Medicare billing, Indiana enrollment
- Medicare enrollment name: Heart City Health Center Inc
- 46 clinicians in this Medicare group
Alexandria, IN 46001
- Reassigned Medicare billing, Indiana enrollment
- 113 clinicians in this Medicare group
Milwaukee, WI 53221
- Reassigned Medicare billing, Indiana enrollment
- 30 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 46516 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Song Baek's NPI number?
The NPI number for Song Baek is 1679020119. It was assigned to this individual provider in the NPPES registry on September 1, 2016.
Where is Song Baek located?
Song Baek practices at 1004 Parkway Ave Ste E, Elkhart, IN 46516. The listed phone number is (574) 218-7131.
What is Song Baek's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Song Baek enrolled in Medicare?
Yes. Song Baek is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Song Baek's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Song Baek reassigns Medicare benefits to 3 organizations: Healthlinc, Inc (Elkhart, IN), Cleanslate Medical Group Of Indiana LLC (Alexandria, IN) and Informe Healthcare LLC (Milwaukee, WI). 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 Song Baek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Song Baek accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource, Cigna Healthcare and UnitedHealthcare list Song Baek as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Song Baek was last updated on September 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.
# Song I Baek · NPI 1679020119
Family physician in Elkhart, Indiana. Individual provider, active in the CMS NPPES registry since September 1, 2016.
## Identity
- **NPI:** 1679020119 (Entity type: Individual)
- **Enumerated:** September 1, 2016
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 71006583A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 1004 PARKWAY AVE STE E, Elkhart, IN 46516-9349
- **Phone:** (574) 218-7131
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 3 organizations under Medicare reassignment (form CMS-855R): Healthlinc, Inc (NPI 1720033418, Elkhart, IN); Cleanslate Medical Group Of Indiana LLC (NPI 1023464294, Alexandria, IN); Informe Healthcare LLC (NPI 1407343965, Milwaukee, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Michigan Medical School, class of 2016
## Record status
- **NPPES last updated:** September 24, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1679020119) · Data from the CMS NPPES public registry.