DOUGLAS K HENSTROM (M.D.) – Plastic Surgery within the Head & Neck (Otolaryngology) Physician, NPI 1558333179
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
56 PLASTIC AND RECONSTRUCTIVE SURGERY in IA
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Provider Addresses for DOUGLAS K HENSTROM (M.D.)
1700 West, Evergreen Farms, Layton, Davis County, Utah, 84041, United States
STE 200
LAYTON, UT 840411187
Phone: (801) 776-2220
Fax: (801) 820-2772
Type: Mailing
University of Iowa Hospitals & Clinics, 200, Hawkins Drive, Iowa City, Johnson County, Iowa, 52245, United States
IOWA CITY, IA 522421007
Phone: (319) 356-3600
Fax: (319) 356-4547
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 18 Open Payments records for all available years, with a total value of $452.
Total Amount is formed as General ($452) + Research ($0) + Ownership ($0) = $452.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: ABBVIE INC. ($326).
Total Amount
$452
General + Research + Ownership
Payments
18
Total payment records
General Amount
$452
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $326 |
| REVANCE THERAPEUTICS, INC. | $111 |
| Galderma Laboratories, L.P. | $15 |
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: 2017-06-19
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 |
|---|---|---|---|---|
| I20170619001494 | I | Plastic And Reconstructive Surgery | UT | 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 84041)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Plastic And Reconstructive Surgery, Otolaryngology | ID | |
| Plastic And Reconstructive Surgery, Otolaryngology | UT |
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