CASSIDY CARINA LIU KOO
NPI 1497495535
Family Medicine in Grand Terrace, CA
About Cassidy Carina Liu Koo NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CASSIDY CARINA LIU KOO (NPI 1497495535) is an individual family medicine provider in Grand Terrace, California, licensed in California (190520) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS and is a graduate of Un Of California, Riverside, School Of Medicine (2022).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Cassidy Carina Liu Koo 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92313 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.
GRAND TERRACE, CA 92313
GRAND TERRACE, CA 92313
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 Cassidy Koo's NPI number?
The NPI number for Cassidy Koo is 1497495535. It was assigned to this individual provider in the NPPES registry on March 29, 2022.
Where is Cassidy Koo located?
Cassidy Koo practices at 11980 Mount Vernon Ave, Grand Terrace, CA 92313. The listed phone number is (909) 864-1097.
What is Cassidy Koo's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Cassidy Koo enrolled in Medicare?
Yes. Cassidy Koo 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.
When was this NPI record last updated?
The NPPES record for Cassidy Koo was last updated on July 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Cassidy Carina Liu Koo · NPI 1497495535
Family Medicine physician in Grand Terrace, California. Individual provider, active in the CMS NPPES registry since March 29, 2022.
## Identity
- **NPI:** 1497495535 (Entity type: Individual)
- **Enumerated:** March 29, 2022
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 190520 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 11980 MOUNT VERNON AVE, Grand Terrace, CA 92313-5172
- **Phone:** (909) 864-1097
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Un Of California, Riverside, School Of Medicine, class of 2022
## Record status
- **NPPES last updated:** July 15, 2025
---
Source: [NPI Profile](https://npiprofile.com/npi/1497495535) · Data from the CMS NPPES public registry.