Individual provider Active NPI

Edward Sung Bae Pak

  • Emergency Medicine Physician
  • Clackamas, OR
National Provider Identifier
1194353920
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD219369 Issued in OR
Practice address
10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone
(800) 813-2000
NPI assigned
Mar 28, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD70092676 WA
Emergency Medicine Physician 207P00000X MD219369 OR Primary

Addresses

Primary practice location

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970

Mailing address

500 NE Multnomah St Ste 100
Portland, OR 97232-2031
Phone (800) 813-2000

Other practice location 1

1460 G St
Springfield, OR 97477-4112
Phone (541) 726-4400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR, WA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240604002060 OR Practitioner - Emergency Medicine 7315489580 Reassigns benefits to 2 organizations
I20260601000522 WA Practitioner - Emergency Medicine 7315489580 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Loma Linda University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kaiser Foundation Health Plan of the NorthwestGroup PAC ID 5799688230, 1,805 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

10180 SE Sunnyside Rd
Clackamas, OR 97015-8970
Phone (800) 813-2000

14406 NE 20TH Ave
Vancouver, WA 98686-1448
Phone (800) 813-2000

2700 NW Stewart Pkwy
Roseburg, OR 97471-1281
Phone (541) 673-0611

Hospital & facility affiliations

  • Mercy Medical Center Hospital, Roseburg, OR, CCN 380027
  • Kaiser Foundation Hospital Westside Hospital, Hillsboro, OR, CCN 380103

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD70092676WAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Mar 1, 2025 Accepting new patients
Cep America LLC Emergency Medicine Current Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

2700 NW Stewart Pkwy
Roseburg, OR 97471
Phone (541) 673-0611

Interoperability endpoints

  • Direct secure messaging: epak@yourcarecommunity.org

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1194353920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 NE MULTNOMAH ST STE 100",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972322031",
            "telephone_number": "800-813-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10180 SE SUNNYSIDE RD",
            "city": "CLACKAMAS",
            "state": "OR",
            "postal_code": "970158970",
            "telephone_number": "800-813-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1460 G St",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974774112",
            "country_code": "US",
            "telephone_number": "541-726-4400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAK",
        "first_name": "EDWARD",
        "middle_name": "SUNG BAE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WA",
            "license": "MD70092676",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD219369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clackamas, OR

Sources for this page

Verify at the official NPI Registry.