Henrik B Illum, M.D.

Primary specialty

Hematology & Oncology PhysicianTaxonomy code 207RH0003X

License

N0118 Issued in TX

Practice address

1615 Hospital Parkway
Suite 300
Bedford, TX 76022

Phone

(817) 354-5581

Fax

(817) 359-9062

NPI assigned

May 29, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Hematology/OncologyAlso: Internal Medicine, Medical Oncology

Education

Other, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639
• Baylor Scott & White Medical Center Grapevine Hospital, Grapevine, TX, CCN 450563

Merit-based Incentive Payment System (MIPS)

Final score

85.12 of 100Reported as apm

Quality

67.48

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: henriik.illum@txo.ikm.direct-ci.com

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.

• Texas Oncology PA

  • Medical Oncology Physician
  • El Paso, TX
  • NPI 1811944101

  Hematology & Oncology

  Medicare reassignment Care Compare group NPD
• Texas Oncology PA

  • Medical Oncology Physician
  • Pearland, TX
  • NPI 1912174350

  Hematology & Oncology

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baylor Regional Medical Center at Grapevine

  • General Acute Care Hospital
  • Grapevine, TX
  • NPI 1073511762
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Hurst-Euless-Bedford

  • General Acute Care Hospital
  • Bedford, TX
  • NPI 1104845015
  Care Compare affiliation

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1982805164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 HOSPITAL PARKWAY",
            "address_2": "SUITE 300",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "76022",
            "telephone_number": "817-354-5581",
            "fax_number": "817-359-9062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILLUM",
        "first_name": "HENRIK",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "TX",
            "license": "N0118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "194728503",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01449276",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Farshid Ighani, MD
• Meryum Ijazi, PHARMD
• Victoria Ike
• Mihaiela Ilves, CSFA, CST
• Iman Ali MD PA
• Susan Carol Imke, F.N.P.
• Impulse Home Care LLC
• Impulse Pharmacy Incorporated

• Hematology & Oncology Physician in Bedford, TX
• Providers in Bedford, TX by specialty
• Hematology & Oncology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.