Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Song I Baek

Individual provider Family Nurse Practitioner · NPI 1679020119

Song I Baek is a Nurse Practitioner in Elkhart, Indiana. Graduated from University of Michigan Medical School in 2016, 10 years ago. Practices with Cleanslate Medical Group of Indiana LLC, a 61-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Indiana.

Years since qualifying
10
Trained at
University of Michigan Medical School
Licensed in
IN
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1004 Parkway Ave Ste E
Elkhart, IN 46516-9349
Phone: (574) 218-7131
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 71006583A (IN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 28231893A (IN)

Record details

NPI number1679020119
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 1, 2016
Last updated in NPPESSeptember 24, 2025
Certification dateSeptember 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF MICHIGAN MEDICAL SCHOOL
Graduated 2016 (10 years in practice)
Group practice Cleanslate Medical Group Of Indiana Llc — 61 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Elkhart