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BAILEY ELIZABETH HIGBY NP
NPI 1154967123
Nurse Practitioner in Sun Prairie, WI

Active since November 25, 2019PECOS EnrolledAccepts Medicare Assignment
77.43/100
CMS Quality Rating
650 SPRING ST UNIT 5106, SUN PRAIRIE, WI 53590(563) 726-3383 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 20, 2021, Nov 25, 2019 (2 updates tracked since 2019).

About Bailey Elizabeth Higby Np NPPES

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

BAILEY ELIZABETH HIGBY NP (NPI 1154967123) is an individual nurse practitioner in Sun Prairie, Wisconsin, licensed in Wisconsin (9625) and active in the NPI registry since November 2019. She is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1154967123
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameBAILEY ELIZABETH HIGBYCredential: NP
Location Address650 SPRING ST UNIT 5106Sun Prairie, WI 53590-9341
Mailing Address650 Spring St Unit 5106Sun Prairie, WI 53590-9341
Phone(563) 726-3383
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateNovember 25, 2019
Last NPPES UpdateSeptember 20, 20232 updates tracked since enumeration
NPPES CertifiedSeptember 20, 2023
✔ NPI 1154967123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in WI · 9625
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
650 SPRING ST UNIT 5106, Sun Prairie, WI 53590
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW 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

Bailey Elizabeth Higby Np 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 ID1355775313
PECOS Enrollment IDI20191227000912
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.

Areas of Expertise CMS Part B claims 6

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.

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.
94 services78 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.
64 services56 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
42 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
38 services38 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.
26 services26 patients
Aspiration and/or injection of fluid from small joint 20600
This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.
20 services14 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53590 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.43/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.83
Promoting Interoperability77
Improvement Activities40
Cost62.12

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 Bailey Higby's NPI number?

The NPI number for Bailey Higby is 1154967123. It was assigned to this individual provider in the NPPES registry on November 25, 2019.

Where is Bailey Higby located?

Bailey Higby practices at 650 Spring St Unit 5106, Sun Prairie, WI 53590. The listed phone number is (563) 726-3383.

What is Bailey Higby's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Bailey Higby enrolled in Medicare?

Yes. Bailey Higby 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.

What insurance does Bailey Higby accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz list Bailey Higby 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.

Is Bailey Higby affiliated with any hospitals?

According to CMS data, Bailey Higby is affiliated with Unitypoint Health - Meriter and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Bailey Higby was last updated on September 20, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.