NPIMap

Individual provider Active NPI

Eric L Hensen, DO

  • Otolaryngology Physician
  • Palestine, TX
National Provider Identifier
1891864666
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
OS11121 Issued in FL
Practice address
112 Medical Dr
Palestine, TX 75801-4780
Phone
(903) 729-0444
Fax
(903) 729-7765
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery within the Head & Neck (Otolaryngology) Physician 207YX0007X OS11121 FL
Otolaryngology Physician 207Y00000X OS11121 FL Primary

Addresses

Primary practice location

112 Medical Dr
Palestine, TX 75801-4780

Mailing address

112 Medical Dr
Palestine, TX 75801-4780
Phone (903) 729-0444

Other practice location 1

2625 S Florida Ave
Lakeland, FL 33803-3860
Phone (863) 284-5941

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160809003097 TX Practitioner - OtolaryngologyPractitioner - Allergy/ImmunologyPractitioner - Maxillofacial Surgery 4587559653 Reassigns benefits to 2 organizations
I20170315000762 AL Practitioner - Otolaryngology 4587559653 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology, Maxillofacial Surgery
Education
Michigan State University College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 Medical Dr
Palestine, TX 75801-4780
Phone (903) 729-0444

Hospital & facility affiliations

  • Palestine Regional Medical Center Hospital, Palestine, TX, CCN 450747
  • Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
  • Freestone Medical Center Hospital, Fairfield, TX, CCN 450658
  • Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision17
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
8563MTMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Health Management Corporation CurrentSince Feb 1, 2017 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 8, 2016 Accepting new patients
Regional Health Management Corporation CurrentSince Feb 1, 2017 Accepting new patients
Melinda a Duncan DO, PA Otolaryngology CurrentSince Oct 16, 2018 Accepting new patients
Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm CurrentSince Jul 8, 2016 Accepting new patients
San Miguel Clinic Corp PastSince Jul 3, 2017 Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

901 Leighton Ave
Ste 204
Anniston, AL 36207
Phone (256) 235-5015

4212 N 16th St
Phoenix, AZ 85016
Phone (602) 248-4187

112 Medical Dr
Palestine, TX 75801
Phone (214) 729-0444

Organizations & group practices 9

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1891864666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014780",
            "telephone_number": "903-729-0444",
            "fax_number": "903-729-7765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 MEDICAL DR",
            "city": "PALESTINE",
            "state": "TX",
            "postal_code": "758014780",
            "telephone_number": "903-729-0444",
            "fax_number": "903-729-7765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2625 S Florida Ave",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338033860",
            "country_code": "US",
            "telephone_number": "863-284-5941",
            "fax_number": "863-284-5199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENSEN",
        "first_name": "ERIC",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0007X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Plastic Surgery within the Head & Neck",
            "state": "FL",
            "license": "OS11121",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "OS11121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palestine, TX

Sources for this page

Verify at the official NPI Registry.