AMY M HIGGINBOTHAM MS
NPI 1104125020
Counselor - Mental Health in Green Lake, WI
NPI Status: Active since March 17, 2011
Contact Information
571 COUNTY ROAD A
GREEN LAKE, WI
ZIP 54941
Phone: (920) 294-4070
Fax: (920) 294-4139
- Individual
- Female
- Years of Experience 21
- Counselor
- Mental Health
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About AMY HIGGINBOTHAM
This page provides the complete NPI Profile along with additional information for Amy Higginbotham, a provider established in Green Lake, Wisconsin with a medical specialization in Counselor, focusing in mental health and more than 21 years of experience. The healthcare provider is registered in the NPI registry with number 1104125020 assigned on March 2011. The practitioner's primary taxonomy code is 101YM0800X. The provider is registered as an individual and her NPI record was last updated 15 years ago.
- NPI
- 1104125020
- Provider Name
- AMY M HIGGINBOTHAM MS
- Other Name
- AMY M BAUDHUIN MS
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 571 COUNTY ROAD A GREEN LAKE, WI 54941
- Location Phone
- (920) 294-4070
- Location Fax
- (920) 294-4139
- Mailing Address
- PO BOX 588 GREEN LAKE, WI 54941
- Mailing Phone
- (920) 294-4070
- Mailing Fax
- (920) 294-4139
- Medical School Name
- OTHER
- Graduation Year
- 2005
- Is Sole Proprietor?
- No
- Enumeration Date
- 03-17-2011
- Last Update Date
- 03-17-2011
- Code Navigator
A mental health counselor like Amy Higginbotham provides treatment to individuals, families, couples, and groups for mental and emotional health issues and relationship problems. Mental health counselors treat clients with a variety of conditions, including anxiety, depression, grief, low self-esteem, stress, and suicidal impulses.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Counselor Mental Health
- Taxonomy Code
- 101YM0800X
- Type
- Behavioral Health & Social Service Providers
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
- Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
- Anthem Silver Preferred/Broad 4000 ($0 PCP Visits + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Bronze $0 Ded / $2500 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - EPO
- CareSource (Common Ground Healthcare) Bronze $9600 ($45 PCP Copay) - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - EPO
- CareSource (Common Ground Healthcare) Bronze Standard $7500 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - EPO
- CareSource (Common Ground Healthcare) Gold $0 Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - EPO
- CareSource (Common Ground Healthcare) Gold $3300 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - EPO
- CareSource (Common Ground Healthcare) Gold Standard $2000 - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $4700 Ded / $5000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - EPO
- CareSource (Common Ground Healthcare) Silver $5000 Ded / $6000 Rx Ded - Vision Exam - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - EPO
- CareSource (Common Ground Healthcare) Silver Standard $6000 - Vision Exam - EPO
- Atlas $1,300 Gold - PPO
- Atlas $2,000 Standard Gold - PPO
- Atlas $3,050 Plus Silver - PPO
- Atlas $3,800 HSA Silver - PPO
- Atlas $6,000 Standard Silver - PPO
- Atlas $6,800 Plus Bronze HSA - PPO
- Atlas $7,500 Standard Bronze HSA - PPO
- Atlas $8,400 HSA Bronze - PPO
- NE WI Select $3,150 Plus Silver - PPO
- NE WI Select $3,800 HSA Silver - PPO
- NE WI Select $6,000 Standard Silver - PPO
- NE WI Select $6,800 Plus Bronze HSA - PPO
- NE WI Select $7,500 Standard Bronze HSA - PPO
- NE WI Select $8,400 HSA Bronze - PPO
- Oak $1,300 Gold - PPO
- Oak $2,000 Standard Gold - PPO
- Engage by Medica Bronze HSA - EPO
- Engage by Medica Bronze Share - EPO
- Engage by Medica Expanded Bronze Standard - EPO
- Engage by Medica Gold $0 Copay PCP Visits - EPO
- Engage by Medica Gold Share - EPO
- Engage by Medica Gold Standard - EPO
- Engage by Medica Silver $0 Copay PCP Visits - EPO
- Engage by Medica Silver Share - EPO
- Engage by Medica Silver Standard - EPO
- Essentia Choice Care with Medica Bronze HSA - EPO
- Essentia Choice Care with Medica Bronze Share - EPO
- Essentia Choice Care with Medica Expanded Bronze Standard - EPO
- Essentia Choice Care with Medica Gold $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Gold Share - EPO
- Essentia Choice Care with Medica Gold Standard - EPO
- Essentia Choice Care with Medica Silver $0 Copay PCP Visits - EPO
- Essentia Choice Care with Medica Silver Share - EPO
- Essentia Choice Care with Medica Silver Standard - EPO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Amy Higginbotham is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Amy Higginbotham is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 1456702471
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240103004390
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1104125020, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 40. The final step is to find the difference between that total and the next multiple of ten (40 - 40 = 0).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 40 is 40. The difference is the calculated check digit.
Other Providers at the Same Location
The following 16 providers are registered at the same or a nearby location.
GREEN LAKE, WI 54941
GREEN LAKE, WI 54941
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104125020, enumerated as an "individual" on March 17, 2011.
The provider is located at 571 COUNTY ROAD A GREEN LAKE, WI 54941 and the phone number is (920) 294-4070.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, CareSource. Please consult your insurance carrier or call the provider to verify.
