Individual provider Active NPI

Ihsan M Salloum, MD

  • Psychiatry Physician
  • Harlingen, TX
National Provider Identifier
1760457147
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
S6731 Issued in TX
Practice address
2902 Haine Drive
Harlingen, TX 78550
Phone
(956) 296-4000
Fax
(956) 296-2842
NPI assigned
Feb 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME98860 FL
Psychiatry Physician 2084P0800X S6731 TX Primary

Addresses

Primary practice location

2902 Haine Drive
Harlingen, TX 78550

Mailing address

2102 Treasure Hills Blvd Ste 2.126
Harlingen, TX 78550-8736
Phone (956) 296-5527

Other identifiers 3

IdentifierTypeStateIssuer
001179664MedicaidPA
4306227-01MedicaidTX
BCBSOtherTXH08QJ49601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20211020000574 TX Practitioner - Psychiatry 8224195912 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2106 Treasure Hills Blvd
Suite 1326
Harlingen, TX 78550-8736
Phone (833) 887-4863

Merit-based Incentive Payment System (MIPS)

Final score
86.59 of 100Reported as group
Quality
72.49
Promoting interoperability
94
Improvement activities
40
Cost
68.19

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
S6731TXMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The University of Texas Rio Grande Valley CurrentSince Sep 1, 2021 Accepting new patients
The University of Texas Rio Grande Valley Psychiatry CurrentSince Sep 1, 2021 Accepting new patients
University of Texas Rio Grande Valley Past Accepting new patients

Locations

2102 Treasure Hills Blvd
Harlingen, TX 78550
Phone (956) 296-1437

2106 Treasure Hills Blvd
#1326
Harlingen, TX 78550
Phone (956) 296-1519

2102 Treasure Hills Blvd
Ste 2126
Harlingen, TX 78550

2902 Haine Dr
Harlingen, TX 78550
Phone (956) 296-3821

2106 Treasure Hills Blvd
Ste 1
Harlingen, TX 78550
Phone (956) 296-1519

2106 Treasure Hills Blvd
Ste 1326
Harlingen, TX 78550
Phone (956) 296-1519

2810 W Expressway 83
Mercedes, TX 78570
Phone (956) 296-1831

Interoperability endpoints

  • Direct secure messaging: ihsan.salloum.1@27420.direct.athenahealth.com
  • Direct secure messaging: isalloum68282@direct.utmb.edu

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1760457147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2102 TREASURE HILLS BLVD STE 2.126",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "785508736",
            "telephone_number": "956-296-5527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2902 HAINE DRIVE",
            "city": "HARLINGEN",
            "state": "TX",
            "postal_code": "78550",
            "telephone_number": "956-296-4000",
            "fax_number": "956-296-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALLOUM",
        "first_name": "IHSAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-21",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME98860",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S6731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001179664",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4306227-01",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H08QJ49601",
            "identifier": "BCBS",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlingen, TX

Sources for this page

Verify at the official NPI Registry.