CASSIDY CARINA LIU KOO
NPI 1497495535
Family Medicine in Grand Terrace, CA

Q: 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.

Q: What is Cassidy Koo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: 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 15 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.

Active since March 29, 2022PECOS EnrolledAccepts Medicare Assignment

11980 MOUNT VERNON AVE, GRAND TERRACE, CA 92313(909) 864-1097 Get Directions Write a Review

NPPES record last updated: July 15, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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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

NPI1497495535

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameCASSIDY CARINA LIU KOO

Location Address11980 MOUNT VERNON AVEGrand Terrace, CA 92313-5172

Mailing Address11980 Mount Vernon AveGrand Terrace, CA 92313-5172

Phone(909) 864-1097

Sole ProprietorNo

Medical School CMSUn Of California, Riverside, School Of MedicineGraduated 2022

Enumeration DateMarch 29, 2022

Last NPPES UpdateJuly 15, 2025

NPPES CertifiedJuly 15, 2025

✔ NPI 1497495535 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · 190520

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

11980 MOUNT VERNON AVE, Grand Terrace, CA 92313

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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

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.

PECOS PAC ID1254706450

PECOS Enrollment IDI20251011000095

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Cassidy Koo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Riverside-San Bernardino County Indian Health, Inc.

Same address

Federally Qualified Health Center (FQHC)

11980 MOUNT VERNON AVE
Grand Terrace, CA 92313

Reassigned Medicare billing, Texas enrollment
101 clinicians in this Medicare group

NPI 1174676670 (909) 864-1097

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 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.

New Patient

$91.88 typical visit price

range $59.60 – $179.42

Typical copayment $22.97 (range $14.90 – $44.85)

Most-billed visit code 99203

Established Patient

$104.64 typical visit price

range $19.37 – $146.42

Typical copayment $26.16 (range $4.84 – $36.60)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

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