Husam Srour Mallah, MD in Glendale, AZ

Husam Srour Mallah, MD is a medicare enrolled "Pediatrics - Pediatric Gastroenterology" physician in Glendale, Arizona. His current practice location is 5757 W Thunderbird Rd Ste W310, Glendale, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 865-4011.

Husam Srour Mallah is licensed to practice in Indiana (license number 01067525A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1912048703.

Contact Information

	Husam Srour Mallah, MD
	5757 W Thunderbird Rd Ste W310, Glendale, AZ 85306-4644
	(602) 865-4011
	(602) 865-4250

Map and Direction

Physician's Profile

Full Name	Husam Srour Mallah
Gender	Male
Speciality	Pediatrics - Pediatric Gastroenterology
Location	5757 W Thunderbird Rd Ste W310, Glendale, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1912048703
Provider Enumeration Date: 02/12/2007
Last Update Date: 09/29/2015

Medicare PECOS Information:

PECOS PAC ID: 8325232432
Enrollment ID: I20150915002009

Medical Identifiers

Medical identifiers for Husam Srour Mallah such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1912048703	NPI	-	NPPES
000000664359	Other	IN	ANTHEM
200987180	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	01067525A (Indiana)	Secondary
2080P0206X	Pediatrics - Pediatric Gastroenterology	01067525A (Indiana)	Primary

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. Husam Srour Mallah allows following entities to bill medicare on his behalf.

Entity Name	Banner Physician Super Specialists Arizona Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1841573870 PECOS PAC ID: 7911173794 Enrollment ID: O20111228000353

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. Husam Srour Mallah 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 Address	Practice Location Address
Husam Srour Mallah, MD 5757 W Thunderbird Rd Ste W310, Glendale, AZ 85306-4644 Ph: (602) 865-4011	Husam Srour Mallah, MD 5757 W Thunderbird Rd Ste W310, Glendale, AZ 85306-4644 Ph: (602) 865-4011

Reviews and Comments

Pediatrics Doctors in Glendale, AZ

Dr. Tich-hao Mach, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 6114 N 59th Ave Ste 4, Glendale, AZ 85301 Phone: 623-937-8643
Susanna Emilia Rantanen, PA Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3575 W Deer Valley Rd, Glendale, AZ 85308 Phone: 480-585-5200
Amit Jain, M.D., M.B.A. Pediatrics Medicare: Medicare Enrolled Practice Location: 6206 W Bell Rd, Glendale, AZ 85308 Phone: 480-882-4545 Fax: 602-863-5851
Michael I Berman, DO Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 18700 N 64th Dr, Ste 301, Glendale, AZ 85308 Phone: 623-561-5437 Fax: 623-561-9320
Ms. Carmen M Rivera, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 7734 N 59th Ave, Glendale, AZ 85301 Phone: 602-569-3999 Fax: 602-569-3887
Mr. Jason Daniel Vargas, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5940 W Union Hills Dr, Suite D-100, Glendale, AZ 85308 Phone: 602-978-2500 Fax: 602-938-2198
Kay Frances Navarrette, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 5940 W Union Hills Dr, Suite D100, Glendale, AZ 85308 Phone: 602-978-2500 Fax: 602-938-2198

Husam Srour Mallah, MD - Medicare Pediatrics in Glendale, AZ