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DR. DOUGLAS ALAN HEIGHTON M.D.
NPI 1184661076
Family Medicine in Carthage, IL

Active since June 01, 2006PECOS EnrolledAccepts Medicare Assignment
95.01/100
CMS Quality Rating
630 LOCUST ST, CARTHAGE, IL 62321(217) 357-2173(217) 357-3610 Get Directions Write a Review

NPPES record last updated: January 28, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Douglas Alan Heighton M.d. NPPES

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

DR. DOUGLAS ALAN HEIGHTON M.D. (NPI 1184661076) is an individual family medicine provider in Carthage, Illinois, licensed in Illinois (036.124727) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Mc Donough District Hospital, and is a graduate of Wright State University Boonshoft School Of Medicine (1998).

NPPES Registry Identity

NPI1184661076
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. DOUGLAS ALAN HEIGHTONCredential: M.D.
Location Address630 LOCUST STCarthage, IL 62321-1459
Mailing Address630 Locust StCarthage, IL 62321-1459 · (217) 357-2173 · Fax (217) 357-3610
Phone(217) 357-2173
Fax(217) 357-3610
Sole ProprietorNo
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 1998
Enumeration DateJune 1, 2006
Last NPPES UpdateJanuary 28, 2011
✔ NPI 1184661076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in IL · 036.124727✔ Licensed in OH · 035..077436
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
630 LOCUST ST, Carthage, IL 62321
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Other Identifiers 1

Medicare PIN0350423

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. Douglas Alan Heighton M.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 ID244271914
PECOS Enrollment IDI20100714000728
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.

Hospital Affiliations CMS Care Compare 3

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

Mc Donough District Hospital

Acute Care Hospitals · Macomb, IL
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number140089
Location525 East Grant StreetMacomb, IL 61455 · Mc Donough County
Emergency services Birthing friendly

Memorial Hospital

Critical Access Hospitals · Carthage, IL
OwnershipVoluntary non-profit - Private
CMS Certification Number141305
Location1454 N County Road 2050 ECarthage, IL 62321 · Hancock County
Emergency services

Southeast Iowa Regional Medical Center

Acute Care Hospitals · West Burlington, IA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number160057
Location1221 South Gear AvenueWest Burlington, IA 52655 · Des Moines County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62321 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
$85.71 typical visit price
range $54.80 – $168.44
Typical copayment $21.42 (range $13.70 – $42.11)
Most-billed visit code 99203
Established Patient
$97.25 typical visit price
range $17.16 – $136.56
Typical copayment $24.31 (range $4.29 – $34.14)
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.

95.01/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality80.02
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 22

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers63 claims126 services$5.75 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
4 suppliers17 claims17 services$1.14 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers46 claims46 services$42.25 avg. paid by Medicare
Administration set, with small volume nonfiltered pneumatic nebulizer, non-disposable A7005
DME-Other DME · category DE000N
3 suppliers11 claims11 services$19.21 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
3 suppliers40 claims40 services$119.63 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers35 claims102 services$44.67 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

MS. DAVEDA C VOSS NP
Nurse Practitioner (Family)
630 LOCUST ST
CARTHAGE, IL 62321
Hancock County (217) 357-2173
PHILIP RALPH CAROPRESO M.D.
Surgery
630 LOCUST ST
CARTHAGE, IL 62321
Hancock County (217) 357-2173
MRS. KRISTA M CARLE APN-BC
Nurse Practitioner
630 LOCUST ST
CARTHAGE, IL 62321
Hancock County (217) 357-2173
KATHERINE RUEBUSH
Physical Therapist
630 LOCUST ST
CARTHAGE, IL 62321
Hancock County (217) 354-6560

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 Douglas Heighton's NPI number?

The NPI number for Douglas Heighton is 1184661076. It was assigned to this individual provider in the NPPES registry on June 1, 2006.

Where is Douglas Heighton located?

Douglas Heighton practices at 630 Locust St, Carthage, IL 62321. The listed phone number is (217) 357-2173.

What is Douglas Heighton's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Douglas Heighton enrolled in Medicare?

Yes. Douglas Heighton 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.

Is Douglas Heighton affiliated with any hospitals?

According to CMS data, Douglas Heighton is affiliated with Mc Donough District Hospital, Memorial Hospital and Southeast Iowa Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Douglas Heighton was last updated on January 28, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.