DR. DAE KEUN JOO M.D.
NPI 1164757076
Otolaryngology in Riverside, CA
About Dr. Dae Keun Joo M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. DAE KEUN JOO M.D. (NPI 1164757076) is an individual otolaryngology provider in Riverside, California, licensed in California (A93394) and active in the NPI registry since October 2009. He is enrolled in Medicare PECOS and is a graduate of University Of Cincinnati College Of Medicine (2004).
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Dae Keun Joo 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.
Medicare Billing Reassignments
2Medicare enrollment records show Dae Joo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Riverside, CA 92505
- Reassigned Medicare billing, California enrollment
- Also billed through NPI 1952333460 (California)
- 5,228 clinicians in this Medicare group
Riverside, CA 92505
- Reassigned Medicare billing, California enrollment
- 2,584 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92505 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
RIVERSIDE, CA 92505
RIVERSIDE, CA 92505
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 Dae Joo's NPI number?
The NPI number for Dae Joo is 1164757076. It was assigned to this individual provider in the NPPES registry on October 9, 2009. The provider is also known as Dr. Daekeun Joo M.D..
Where is Dae Joo located?
Dae Joo practices at 10800 Magnolia Ave, Riverside, CA 92505. The listed phone number is (951) 353-4738.
What is Dae Joo's specialty?
The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.
Is Dae Joo enrolled in Medicare?
Yes. Dae Joo 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.
Which organizations bill Medicare for Dae Joo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dae Joo reassigns Medicare benefits to 2 organizations: Southern California Permanente Medical Group (Riverside, CA) and Faculty Physicians And Surgeons Of Llusm (Riverside, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dae Joo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Dae Joo was last updated on October 18, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Dr. Dae Keun Joo, M.D. · NPI 1164757076
Otolaryngology physician in Riverside, California. Individual provider, active in the CMS NPPES registry since October 9, 2009.
## Identity
- **NPI:** 1164757076 (Entity type: Individual)
- **Enumerated:** October 9, 2009
- **Primary specialty:** Otolaryngology · taxonomy 207Y00000X
- **State license:** A93394 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10800 MAGNOLIA AVE, Riverside, CA 92505-3043
- **Phone:** (951) 353-4738
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Southern California Permanente Medical Group (NPI 1316979834, Riverside, CA); Faculty Physicians And Surgeons Of Llusm (NPI 1033361886, Riverside, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Cincinnati College Of Medicine, class of 2004
## Record status
- **NPPES last updated:** October 18, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1164757076) · Data from the CMS NPPES public registry.