Individual provider Active NPI

Haysam Baho, M.D.

  • Pediatric Cardiology Physician
  • Manassas, VA
National Provider Identifier
1710110366
Registry record updated Jul 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
License
MD2024-0880 Issued in NM
Practice address
9548 Surveyor CT
Manassas, VA 20110-4406
Phone
(703) 369-9090
Fax
(703) 392-9646
NPI assigned
Aug 31, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology Physician 2080P0202X MD2024-0880 NM Primary

Addresses

Primary practice location

9548 Surveyor CT
Manassas, VA 20110-4406

Mailing address

800 Bradbury Dr SE Ste 116
Albuquerque, NM 87106-4310
Phone (505) 272-1476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231000423 NM Practitioner - Pediatric MedicinePractitioner - Cardiovascular Disease (Cardiology) 2466989579 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Unm Medical Group Inc CurrentSince Oct 16, 2024 Accepting new patients
Unm Medical Group, Inc. CurrentSince Oct 16, 2024 Accepting new patients
Children'S Heart Institute Specialist Past Accepting new patients

Locations

800 Bradbury Dr SE
Ste 116
Albuquerque, NM 87106
Phone (505) 272-1476

3001 Broadmoor Blvd NE
Rio Rancho, NM 87144
Phone (505) 994-7000

2211 Lomas Blvd NE
Unm, NM 87106
Phone (505) 272-1111

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782864000000",
    "number": "1710110366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 BRADBURY DR SE STE 116",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064310",
            "telephone_number": "505-272-1476",
            "fax_number": "703-724-4408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9548 SURVEYOR CT",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201104406",
            "telephone_number": "703-369-9090",
            "fax_number": "703-392-9646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAHO",
        "first_name": "HAYSAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-31",
        "last_updated": "2026-07-01",
        "certification_date": "2026-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "NM",
            "license": "MD2024-0880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

Verify at the official NPI Registry.