DR. SHAUN DOUGLAS MENDENHALL (M.D.) – Plastic Surgery Physician, NPI 1023305018
Plastic Surgery Physician
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Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
64 PLASTIC AND RECONSTRUCTIVE SURGERY in UT
Provider Addresses for DR. SHAUN DOUGLAS MENDENHALL (M.D.)
30 N 1900 E # 3B400
SALT LAKE CITY, UT 84132
Phone: (801) 581-7719
Fax: (801) 581-5797
Type: Location
30 N 1900 E RM 6152
SALT LAKE CITY, UT 841320002
Phone: (801) 581-7719
Fax: (801) 581-5797
Type: Mailing
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 191044319
Phone: (215) 590-2208
Fax: (215) 590-2496
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 66 Open Payments records for all available years, with a total value of $92,443.
Total Amount is formed as General ($92,443) + Research ($0) + Ownership ($0) = $92,443.
Last reported payment date: 2024-12-09 • Largest payer in this snapshot: PolyNovo North America LLC ($91,819).
Total Amount
$92,443
General + Research + Ownership
Payments
66
Total payment records
General Amount
$92,443
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| PolyNovo North America LLC | $91,819 |
| TELA Bio, Inc. | $172 |
| Stryker Corporation | $162 |
| Checkpoint Surgical, Inc | $153 |
| AXOGEN | $97 |
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: 2021-08-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20180531000513 | I | Plastic And Reconstructive Surgery | UT | TBD |
| I20210806000249 | I | Plastic And Reconstructive Surgery | PA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84132)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | UT | |
| - | UT | |
| Emergency Medicine | CO | |
| - | UT | |
| A N E S T H E S I O L O G Y | UT | |
| Physician Assistant | UT | |
| - | IL | |
| Plastic And Reconstructive Surgery | OH | |
| Physician Assistant | CA | |
| Physician Assistant | UT |
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