Song I Baek

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71006583A Issued in IN

Practice address

1004 Parkway Ave Ste E
Elkhart, IN 46516-9349

Phone

(574) 218-7131

NPI assigned

Sep 1, 2016

Last updated

Sep 24, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

University of Michigan Medical School, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

76.22 of 100Reported as group

Quality

35

Improvement activities

40

Cost

74.08

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

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.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment Care Compare group NPD
• Informe Healthcare LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1407343965

  Family, IN

  Medicare reassignment NPD
• Healthlinc, Inc

  • Community Health Clinic/Center
  • Elkhart, IN
  • NPI 1720033418
  Medicare reassignment
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)
• Planned Parenthood Great Northwest, Hawai'I, Alaska, Indiana, Kentucky

  • Non-Surgical Family Planning Clinic/Center
  • Honolulu, HI
  • NPI 1558424473
  NPD (past)

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

{
    "created_epoch": "1472688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1679020119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 PARKWAY AVE STE E",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169349",
            "telephone_number": "574-218-7131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 PARKWAY AVE STE E",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465169349",
            "telephone_number": "574-218-7131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAEK",
        "first_name": "SONG",
        "middle_name": "I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-01",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71006583A",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "28231893A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• B.a. Vernon Counseling, LLC
• Brandon John Babb, DPT
• Michelle R Bache, MD
• Sarah Bachman, RBT
• Brenda Gayle Bachmann, P.A.
• Monica Bahena
• Mary Roxanne Baker, MS, LMHCA, NCC
• Angela Marie Ball, FNP
• Briana Ball, BCBA
• Lindsey Rae Silver Balliet, MSW

• Family Nurse Practitioner in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; 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.