John Yong Bae

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

209028606 Issued in IL

Practice address

1717 W Crystal LN
Mount Prospect, IL 60056-5459

Phone

(224) 210-0122

NPI assigned

Oct 30, 2023

Last updated

Oct 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

CMC Healthcare LLCGroup PAC ID 4688039209, 133 clinicians

Trio Health Medical Il Psychiatry Partners PLLCGroup PAC ID 7416453618, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• CMC Healthcare LLC

  • Nurse Practitioner
  • Evanston, IL
  • NPI 1295432334
  Medicare reassignment Care Compare group NPD
• Trio Health Medical Il Psychiatry Partners PLLC

  • Psychiatry Physician
  • Evanston, IL
  • NPI 1831071646
  Medicare reassignment Care Compare group NPD
• Total Care Solutions, SC

  • Geriatric Psychiatry Physician
  • Westchester, IL
  • NPI 1447550603
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698624000000",
    "number": "1083486344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 W CRYSTAL LN",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600565459",
            "telephone_number": "224-210-0122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W CRYSTAL LN",
            "city": "MOUNT PROSPECT",
            "state": "IL",
            "postal_code": "600565459",
            "telephone_number": "224-210-0122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAE",
        "first_name": "JOHN",
        "middle_name": "YONG",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-30",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209028606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parviz Ayrempour
• Shankar Ayyaswamy
• Leonid Ayzenberg, M.D
• Azk Transportation Inc
• Divya Babbar, D.O.
• Daniela Valeria Baez, AGPCNP-BC
• Diana Balbarin, APRN
• Karina Balderas, LCSW
• Feyintolu Morayo Balogun, D.P.M.
• Amy Baltes, RD

• Psychiatric/Mental Health Nurse Practitioner in Mount Prospect, IL
• Providers in Mount Prospect, IL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.