SELENE CLARISSA KOO MD, PHD
NPI 1205122967
Pathology - Pediatric Pathology in Memphis, TN
About Selene Clarissa Koo Md, Phd NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SELENE CLARISSA KOO MD, PHD (NPI 1205122967) is an individual pediatric pathology provider in Memphis, Tennessee, licensed in Tennessee (62776) and active in the NPI registry since June 2011. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Locations 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Selene Clarissa Koo Md, Phd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Selene Koo reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Memphis, TN 38105
- Reassigned Medicare billing, Tennessee enrollment
- Medicare enrollment name: St Jude Childrens Research Hospital Inc
- 367 clinicians in this Medicare group
Columbus, OH 43205
- Reassigned Medicare billing, Ohio enrollment
- 30 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 38105 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.
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
MEMPHIS, TN 38105
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 Selene Koo's NPI number?
The NPI number for Selene Koo is 1205122967. It was assigned to this individual provider in the NPPES registry on June 21, 2011.
Where is Selene Koo located?
Selene Koo practices at 262 Danny Thomas Pl, Memphis, TN 38105. The listed phone number is (888) 226-4343.
What is Selene Koo's specialty?
The primary specialty registered for this NPI is Pathology, specializing in Pediatric Pathology, with taxonomy code 207ZP0213X.
Is Selene Koo enrolled in Medicare?
Yes. Selene Koo is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Selene Koo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Selene Koo reassigns Medicare benefits to 2 organizations: St Jude Children's Research Hospital, Inc. (Memphis, TN) and Pediatric Pathology Associates Of Columbus Inc (Columbus, OH). 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 Selene Koo'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 Selene Koo was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 months 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.
# Selene Clarissa Koo, MD, PHD · NPI 1205122967
Pediatric Pathology physician in Memphis, Tennessee. Individual provider, active in the CMS NPPES registry since June 21, 2011.
## Identity
- **NPI:** 1205122967 (Entity type: Individual)
- **Enumerated:** June 21, 2011
- **Primary specialty:** Pathology - Pediatric Pathology · taxonomy 207ZP0213X
- **State license:** 62776 (Tennessee)
- **Sole proprietor:** No
## Practice location
- **Address:** 262 DANNY THOMAS PL, Memphis, TN 38105-3678
- **Phone:** (888) 226-4343
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **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): St Jude Children's Research Hospital, Inc. (NPI 1306335088, Memphis, TN); Pediatric Pathology Associates Of Columbus Inc (NPI 1700860962, Columbus, OH) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1205122967) · Data from the CMS NPPES public registry.