DR. HAITHAM BOULOS HADDAD (M.D.) – Internal Medicine Physician, NPI 1922003714

DR. HAITHAM BOULOS HADDAD (M.D.) is a healthcare provider. based in Grants pass, Oregon. specializing in INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD18812 (OR). The NPI Number for DR. HAITHAM BOULOS HADDAD (M.D.) is 1922003714

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
DR. HAITHAM BOULOS HADDAD (M.D.)
NPI
1922003714
Phone
(541) 476-6644
Address
495 SW RAMSEY AVE
Enumeration Date
17 June 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
LOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5414766644
Graduation Year
1993 (33 years ago)
PAC ID
0648261917
Group Practice PAC ID
9234123977
Professional Enrollment ID
I20040524001289
Address ID
OR975275681GR495XXAVEX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,474 INTERNAL MEDICINE in OR

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Provider Addresses for DR. HAITHAM BOULOS HADDAD (M.D.)

  • 495, Ramsey Avenue, Grants Pass, Josephine County, Oregon, 97527, United States

    GRANTS PASS, OR 97527

    Phone: (541) 476-6644

    Fax: (541) 472-5673

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-05-24

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040524001289IInternal MedicineORTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
36415Insertion of needle into vein for collection of blood sample457178$0
80053Blood test, comprehensive group of blood chemicals361169$0
85025Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count313164$0
99215Established patient office or other outpatient visit, 40-54 minutes286133$0
99214Established patient office or other outpatient visit, 30-39 minutes217135$0
View full utilization report →

Insurance plans in this area (ZIP 97527)

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Provider's Procedures

DR. HAITHAM BOULOS HADDAD (M.D.) performs procedures in INTERNAL MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
INTERNAL MEDICINEOR83036Hemoglobin A1C level17997
INTERNAL MEDICINEOR85610Blood test, clotting time22133

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9234123977View full group profile
NameSpecialtyState
-OR
Family PracticeOR
Physician AssistantOR
Family PracticeOR
Physician AssistantOR
Internal MedicineOR
General SurgeryOR
P O D I A T R YOR
Internal MedicineOR
Nurse PractitionerOR

Reviews

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Frequently asked questions

What is the registry number for DR. HAITHAM BOULOS HADDAD (M.D.)?
The registry entry for DR. HAITHAM BOULOS HADDAD (M.D.) shows NPI 1922003714.
Does the public listing show DR. HAITHAM BOULOS HADDAD (M.D.) as active?
DR. HAITHAM BOULOS HADDAD (M.D.)'s NPI record reflects an active status in NPPES.
Which specialty label fits DR. HAITHAM BOULOS HADDAD (M.D.)?
NPPES ties DR. HAITHAM BOULOS HADDAD (M.D.) to Internal Medicine Physician in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. HAITHAM BOULOS HADDAD (M.D.)?
DR. HAITHAM BOULOS HADDAD (M.D.) is associated with Grants Pass, Oregon in the same public data insurers reference.
Who maintains DR. HAITHAM BOULOS HADDAD (M.D.)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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