Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. CLARK R HIGGANBOTHAM
NPI 1164042560
Urology in Tulsa, OK

Q: What is Clark Higganbotham's NPI number?

The NPI number for Clark Higganbotham is 1164042560. It was assigned to this individual provider in the NPPES registry on April 26, 2020.

Q: What is Clark Higganbotham's specialty?

The primary specialty registered for this NPI is Urology with taxonomy code 208800000X.

Active since April 26, 2020PECOS Enrolled

10901 E 48TH ST, TULSA, OK 74146(918) 749-8765(918) 392-2155 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mr. Clark R Higganbotham NPPES

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

MR. CLARK R HIGGANBOTHAM (NPI 1164042560) is an individual urology provider in Tulsa, Oklahoma, licensed in Oklahoma (47339) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164042560

Entity TypeIndividualMale

Primary Taxonomy208800000X

Provider Legal NameMR. CLARK R HIGGANBOTHAM

Location Address10901 E 48TH STTulsa, OK 74146-5830

Mailing Address10901 E 48th StTulsa, OK 74146-5830 · (918) 749-8765 · Fax (918) 392-2155

Phone(918) 749-8765

Fax(918) 392-2155

Sole ProprietorNo

Enumeration DateApril 26, 2020

Last NPPES UpdateJune 25, 2026

NPPES CertifiedJune 25, 2026

✔ NPI 1164042560 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyUrologyAllopathic & Osteopathic Physicians

Taxonomy Code208800000X

License✔ Licensed in OK · 47339

Definition

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.

10901 E 48TH ST, Tulsa, OK 74146

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Clark R Higganbotham is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 74146 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

$123.06 typical visit price

range $53.00 – $162.61

Typical copayment $30.76 (range $13.25 – $40.65)

Most-billed visit code 99204

Established Patient

$66.48 typical visit price

range $16.68 – $132.40

Typical copayment $16.62 (range $4.17 – $33.10)

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 20

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

KEVIN JOSEPH GANCARCZYK M.D.

Urology