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KATHY KIRYANG BAK M.D.
NPI 1861412884
Family Medicine in Portland, OR

Active since July 20, 2006PECOS EnrolledAccepts Medicare Assignment
87.76/100
CMS Quality Rating
12400 NW CORNELL RD STE 100, PORTLAND, OR 97229(503) 291-4000 Get Directions Write a Review

NPPES record last updated: October 27, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kathy Kiryang Bak M.d. NPPES

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

KATHY KIRYANG BAK M.D. (NPI 1861412884) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (MD164294) and active in the NPI registry since July 2006. She is enrolled in Medicare PECOS, is affiliated with Providence St Vincent Medical Center, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1861412884
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKATHY KIRYANG BAKCredential: M.D.
Location Address12400 NW CORNELL RD STE 100Portland, OR 97229-5689
Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494
Phone(503) 291-4000
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateJuly 20, 2006
Last NPPES UpdateOctober 27, 2023
NPPES CertifiedOctober 27, 2023
✔ NPI 1861412884 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in OR · MD164294✔ Licensed in CA · A91888
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
12400 NW CORNELL RD STE 100, Portland, OR 97229
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Other Identifiers 1

Medicaid500674133OR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Providence Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kathy Kiryang Bak M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9335177476
PECOS Enrollment IDI20131114000034
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.

Areas of Expertise CMS Part B claims 5

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
161 services83 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
132 services93 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
59 services52 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
37 services33 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
31 services31 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Providence St Vincent Medical Center

Acute Care Hospitals · Portland, OR
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380004
Location9205 SW Barnes RoadPortland, OR 97225 · Washington County
Emergency services Birthing friendly

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97229 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

87.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality85.17
Promoting Interoperability100
Improvement Activities40
Cost74.03

Other Providers at the Same Location NPPES 6

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

ANNE M WILLIS PSYD
Psychologist (Clinical)
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000
JESSICA M HARPER PA-C
Physician Assistant
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000
ELIZABETH A BESWICK PSYD
Psychologist (Clinical)
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000
RAQUEL A BISHOP FNP
Nurse Practitioner (Family)
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000
VIVIAN C TSANG FNP
Nurse Practitioner (Family)
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000
PATRICK SCOTT WILLIAMS MD
Family Medicine
12400 NW CORNELL RD STE 100
PORTLAND, OR 97229
Washington County (503) 291-4000

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 Kathy Bak's NPI number?

The NPI number for Kathy Bak is 1861412884. It was assigned to this individual provider in the NPPES registry on July 20, 2006.

Where is Kathy Bak located?

Kathy Bak practices at 12400 NW Cornell Rd Ste 100, Portland, OR 97229. The listed phone number is (503) 291-4000.

What is Kathy Bak's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kathy Bak enrolled in Medicare?

Yes. Kathy Bak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kathy Bak accept?

Health plans from Providence Health Plan list Kathy Bak 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.

Is Kathy Bak affiliated with any hospitals?

According to CMS data, Kathy Bak is affiliated with Providence St Vincent Medical Center and Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Kathy Bak was last updated on October 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.