DOUGLAS M PHAN (M.D.) – Otolaryngology Physician, NPI 1013073766
Otolaryngology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,359 OTOLARYNGOLOGY in CA
Provider Addresses for DOUGLAS M PHAN (M.D.)
927, Broadway Street, Quincy, Adams County, Illinois, 62301, United States
SUITE 322
QUINCY, IL 623012719
Phone: (217) 223-8400
Type: Mailing
1541 FLORIDA AVE STE 304
MODESTO, CA 953504439
Phone: (209) 577-3388
Fax: (209) 521-3262
Type: Location
927 Broadway St
Suite 322
Quincy, IL 623012719
Phone: (217) 223-8400
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $186.
Total Amount is formed as General ($186) + Research ($0) + Ownership ($0) = $186.
Last reported payment date: 2024-10-17 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($109).
Total Amount
$186
General + Research + Ownership
Payments
6
Total payment records
General Amount
$186
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $109 |
| Coherus Biosciences Inc. | $40 |
| KLS-Martin L.P. | $37 |
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: 2017-05-24
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170524002964 | I | Otolaryngology | CA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 277 | 193 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 246 | 246 | $0 |
| 92504 | Exam of ear using a microscope | 103 | 75 | $0 |
| 31575 | Diagnostic exam of voice box using a flexible endoscope | 24 | 23 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 21 | 21 | $0 |
Insurance plans in this area (ZIP 62301)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| General Surgery | CA | |
| Orthopedic Surgery, Sports Medicine | CA | |
| Orthopedic Surgery, Sleep Medicine | CA | |
| General Surgery | CA | |
| Orthopedic Surgery | CA |
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