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DR. HUSAM SROUR MALLAH MD
NPI 1912048703
Pediatrics - Pediatric Gastroenterology in Glendale, AZ

Active since February 12, 2007PECOS Enrolled
5310 W THUNDERBIRD RD STE W311, GLENDALE, AZ 85306(602) 865-4230(602) 865-4250 Get Directions Write a Review

NPPES record last updated: January 1, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 1, 2026, Sep 29, 2015 (2 updates tracked since 2015).

About Dr. Husam Srour Mallah Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HUSAM SROUR MALLAH MD (NPI 1912048703) is an individual pediatric gastroenterology provider in Glendale, Arizona, licensed in Arizona (50552) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1912048703
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NameDR. HUSAM SROUR MALLAHCredential: MD
Location Address5310 W THUNDERBIRD RD STE W311Glendale, AZ 85306-4706
Mailing Address5310 W Thunderbird Rd Ste W311Glendale, AZ 85306-4706 · (602) 865-4230 · Fax (602) 865-4250
Phone(602) 865-4230
Fax(602) 865-4250
Sole ProprietorNo
Enumeration DateFebruary 12, 2007
Last NPPES UpdateJanuary 1, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 1, 2026
✔ NPI 1912048703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License✔ Licensed in AZ · 50552
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Also ListedPediatricsTaxonomy 208000000X · License 50552 (AZ)
5310 W THUNDERBIRD RD STE W311, Glendale, AZ 85306
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Husam Srour Mallah Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Reassignments

2

Medicare enrollment records show Husam Srour Mallah reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Banner Physician Super Specialists Arizona LLC
Same address
Nutrition, Education
5310 W THUNDERBIRD RD STE 214
Glendale, AZ 85306
  • Reassigned Medicare billing, Arizona enrollment
  • 188 clinicians in this Medicare group
NPI 1578125738 (602) 865-4480
Banner-University Medical Group
11 mi
Multi-Specialty
2901 N CENTRAL AVE
Phoenix, AZ 85012
  • Reassigned Medicare billing, Arizona enrollment
  • 1,514 clinicians in this Medicare group
NPI 1508809427 (602) 747-4000

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 85306 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
$127.71 typical visit price
range $55.44 – $168.60
Typical copayment $31.92 (range $13.86 – $42.15)
Most-billed visit code 99204
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

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 Husam Srour Mallah's NPI number?

The NPI number for Husam Srour Mallah is 1912048703. It was assigned to this individual provider in the NPPES registry on February 12, 2007.

Where is Husam Srour Mallah located?

Husam Srour Mallah practices at 5310 W Thunderbird Rd Ste W311, Glendale, AZ 85306. The listed phone number is (602) 865-4230.

What is Husam Srour Mallah's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Husam Srour Mallah enrolled in Medicare?

Yes. Husam Srour Mallah is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Husam Srour Mallah's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Husam Srour Mallah reassigns Medicare benefits to 2 organizations: Banner Physician Super Specialists Arizona LLC (Glendale, AZ) and Banner-University Medical Group (Phoenix, AZ). 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 Husam Srour Mallah's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Husam Srour Mallah accept?

Health plans from Ambetter from Arizona Complete Health, Blue Cross Blue Shield of Arizona, Oscar Health Plan, Inc. and UnitedHealthcare list Husam Srour Mallah as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Husam Srour Mallah was last updated on January 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.