Kassandra Iva Marie Cooper, DO - Medicare Emergency Medicine in Peoria, IL

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Kassandra Iva Marie Cooper, DO is a medicare enrolled "Emergency Medicine" physician in Peoria, Illinois. Her current practice location is 530 Ne Glen Oak Ave, Peoria, Illinois. You can reach out to her office (for appointments etc.) via phone at (309) 655-6710.

Kassandra Iva Marie Cooper is licensed to practice in California (license number 20A15660) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1710393913.

Contact Information

Kassandra Iva Marie Cooper, DO
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001
(309) 655-6710
Not Available

Map and Direction




Physician's Profile

Full NameKassandra Iva Marie Cooper
GenderFemale
SpecialityEmergency Medicine
Location530 Ne Glen Oak Ave, Peoria, Illinois
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1710393913
  • Provider Enumeration Date: 07/08/2014
  • Last Update Date: 11/14/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 7416278346
  • Enrollment ID: I20170912002957

Medical Identifiers

Medical identifiers for Kassandra Iva Marie Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710393913NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 20A15660 (California)Primary
207P00000XEmergency Medicine 125065930 (Illinois)Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kassandra Iva Marie Cooper allows following entities to bill medicare on her behalf.
Entity NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kassandra Iva Marie Cooper is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kassandra Iva Marie Cooper, DO
4601 Dale Rd,
Modesto, CA 95356-9718

Ph: (209) 689-1492		Kassandra Iva Marie Cooper, DO
530 Ne Glen Oak Ave,
Peoria, IL 61637-0001

Ph: (309) 655-6710

Reviews and Comments


Emergency Medicine Doctors in Peoria, IL

Dr. Austin Lamb, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 530 N.e. Glen Oak Avenue, Osf St. Francis, Emergency Medicine Residency Program, Peoria, IL 61637
Phone: 309-655-7257    
Philip A Fifield, M.D.
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-2553    Fax: 309-655-2602
Dr. Anthony J Buecker, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 221 Ne Glen Oak Ave, Peoria, IL 61636
Phone: 309-672-5500    
Dr. Mark Phillip Gaudio, M.D.
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-6710    
Michael M Raso, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 1115 N Bourland Ave, Peoria, IL 61606
Phone: 309-264-0730    
Ryan Newberger, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 248-207-2018    
Craig D Koch, M.D
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 530 Ne Glen Oak Ave, Peoria, IL 61637
Phone: 309-655-7257    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.