DR. DONALD J HIGGINS O.D.
NPI 1023147428
Optometrist in Plainville, CT

Q: What is Donald Higgins's NPI number?

The NPI number for Donald Higgins is 1023147428. It was assigned to this individual provider in the NPPES registry on March 4, 2007.

Q: What is Donald Higgins's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Donald Higgins was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 04, 2007PECOS EnrolledAccepts Medicare AssignmentCLIA 07D1103067 · Waiver

74 E MAIN ST, PLAINVILLE, CT 06062(860) 793-9613(860) 747-6880 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Donald J Higgins O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DONALD J HIGGINS O.D. (NPI 1023147428) is an individual optometrist in Plainville, Connecticut, licensed in Connecticut (955) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, holds a CLIA Waiver certificate valid through July 30, 2027, and is a graduate of New England College Of Optometry (1982).

NPPES Registry Identity

NPI1023147428

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. DONALD J HIGGINSCredential: O.D.

Location Address74 E MAIN STPlainville, CT 06062-1936

Mailing Address74 E Main StPlainville, CT 06062-1936 · (860) 793-9613 · Fax (860) 747-6880

Phone(860) 793-9613

Fax(860) 747-6880

Sole ProprietorYes

Medical School CMSNew England College Of OptometryGraduated 1982

Enumeration DateMarch 4, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1023147428 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in CT · 955

Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.

74 E MAIN ST, Plainville, CT 06062

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Other Identifiers 2

Medicare ID-Type Unspecified0623670001

Medicare UPINT22059CT

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Donald J Higgins O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4486787082

PECOS Enrollment IDI20100803000894

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D1103067

Dr Donald J Higgins · Plainville, CT

Active · expires Jul 30, 2027

CLIA Number07D1103067

Laboratory TypePhysician Office

Certificate Effective DateJuly 31, 2025

Certificate Expiration DateJuly 30, 2027

Laboratory DirectorDonald J. Higgins

Laboratory Phone(860) 793-1613

Laboratory LocationDr Donald J Higgins74 E Main Street, Plainville, CT 06062

CLIA data matches this NPI record on: Address

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Microfluid analysis of tears 83861

Microfluid analysis of tears involves collecting a small tear sample to examine its composition. This procedure can help detect health issues like dry eye disease, inflammation, or other eye conditions. It's a non-invasive, painless method for monitoring eye health.

353 services78 patients

Photography of content of eyes 92285

Photography of the content of eyes, also known as ocular photography, captures detailed images of different parts of the eye. It helps identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. The process is non-invasive and painless.

188 services61 patients

Closure of tear duct opening using plug 68761

Closure of the tear duct opening using a plug is a procedure to address excessive tear production. A small device is inserted into the tear duct to block it, reducing tear flow and relieving symptoms. This is a safe, reversible process, often performed in-office.

125 services20 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

122 services81 patients

Established patient complete exam of visual system 92014

An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.

104 services76 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

99 services38 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

90 services35 patients

Multiple measurements of eye fluid pressure over an extended time period 92100

This procedure involves recording the pressure inside your eyes at different times throughout the day. By tracking these changes, it can help detect conditions like glaucoma early, which can prevent vision loss. It's painless and non-invasive.

71 services43 patients

Exam of the internal drainage system of eye 92020

This is a procedure where your doctor examines the eye's internal drainage system, essential for maintaining eye pressure. They use specialized tools to check for blockages or damage that might lead to conditions like glaucoma. It's non-invasive and painless.

69 services42 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

63 services39 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

63 services41 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

15 services15 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

13 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06062 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$138.84 typical visit price

range $60.82 – $183.10

Typical copayment $34.71 (range $15.20 – $45.77)

Most-billed visit code 99204

Established Patient

$75.55 typical visit price

range $19.76 – $149.26

Typical copayment $18.88 (range $4.94 – $37.31)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MARISHA PEARSON LCSW

Social Worker (Clinical)

74 E MAIN ST
PLAINVILLE, CT 06062

Capitol Planning Region (860) 856-3781

HIGGINS OPTICAL, INC

Optometrist (Corneal and Contact Management)

74 E MAIN ST
PLAINVILLE, CT 06062

Capitol Planning Region (860) 793-9613

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Donald Higgins's NPI number?

The NPI number for Donald Higgins is 1023147428. It was assigned to this individual provider in the NPPES registry on March 4, 2007.

Where is Donald Higgins located?

Donald Higgins practices at 74 E Main St, Plainville, CT 06062. The listed phone number is (860) 793-9613.

What is Donald Higgins's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Donald Higgins enrolled in Medicare?

Yes. Donald Higgins is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Does Donald Higgins hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D1103067) is associated with this NPI, valid through July 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Donald Higgins accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Providence Health Plan list Donald Higgins as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Donald Higgins was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.