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LORETTA A HIGGINS NP
NPI 1205839842
Nurse Practitioner in Dover, DE

Active since May 27, 2005PECOS Enrolled
530 S STATE ST STE 107, DOVER, DE 19901(302) 608-5299(302) 608-3885 Get Directions Write a Review

NPPES record last updated: September 22, 2023. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Loretta A Higgins Np NPPES

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

LORETTA A HIGGINS NP (NPI 1205839842) is an individual nurse practitioner in Dover, Delaware, licensed in Delaware (LD-0000109) and active in the NPI registry since May 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1205839842
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLORETTA A HIGGINSCredential: NP
Location Address530 S STATE ST STE 107Dover, DE 19901-3562
Mailing Address640 S State St, Mail Code 3055Dover, DE 19901-3530 · (302) 480-1688 · Fax (302) 480-9807
Phone(302) 608-5299
Fax(302) 608-3885
Sole ProprietorNo
Enumeration DateMay 27, 2005
Last NPPES UpdateSeptember 22, 2023
NPPES CertifiedSeptember 21, 2023
✔ NPI 1205839842 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 DE · LD-0000109
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.
530 S STATE ST STE 107, Dover, DE 19901
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Loretta A Higgins Np 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Loretta Higgins reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Bayhealth Medical Center, Inc
0.1 mi
Medical Oncology
640 S STATE ST
Dover, DE 19901
NPI 1295292183 (302) 744-7000
Delaware Hospice, Inc
36 mi
Hospice and Palliative Medicine
630 CHURCHMANS RD STE 200
Newark, DE 19702
  • Reassigned Medicare billing, Delaware enrollment
  • 29 clinicians in this Medicare group
NPI 1821361072 (302) 478-5707

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
141 services131 patients
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes 99221
Initial hospital inpatient care refers to the first day of your stay in the hospital. This service typically includes a 30-minute check-up with a healthcare professional. They'll assess your health, discuss your condition, and plan your treatment. It's part of ensuring you receive the best possible care.
112 services103 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
91 services70 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
62 services60 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
41 services36 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
28 services24 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19901 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
$88.37 typical visit price
range $57.12 – $173.08
Typical copayment $22.09 (range $14.28 – $43.27)
Most-billed visit code 99203
Established Patient
$100.68 typical visit price
range $18.36 – $141.05
Typical copayment $25.17 (range $4.59 – $35.26)
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.

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.

THERESA LATORRE-TEGTMEIER NP-C
Nurse Practitioner
530 S STATE ST STE 107
DOVER, DE 19901
Kent County (302) 608-5299
MATTHEW P DEBO D.O.
Internal Medicine (Hospice and Palliative Medicine)
530 S STATE ST STE 107
DOVER, DE 19901
Kent County (302) 608-5299
ROBIN LYNN MARACLE AGCNS-BC
Clinical Nurse Specialist
530 S STATE ST STE 107
DOVER, DE 19901
Kent County (302) 608-5299
HOLLY BROWNE C.R.N.P.
Nurse Practitioner
530 S STATE ST STE 107
DOVER, DE 19901
Kent County (302) 608-5299

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 Loretta Higgins's NPI number?

The NPI number for Loretta Higgins is 1205839842. It was assigned to this individual provider in the NPPES registry on May 27, 2005.

Where is Loretta Higgins located?

Loretta Higgins practices at 530 S State St Ste 107, Dover, DE 19901. The listed phone number is (302) 608-5299.

What is Loretta Higgins's specialty?

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

Is Loretta Higgins enrolled in Medicare?

Yes. Loretta Higgins is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Loretta Higgins's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Loretta Higgins reassigns Medicare benefits to 2 organizations: Bayhealth Medical Center, Inc (Dover, DE) and Delaware Hospice, Inc (Newark, DE). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Loretta Higgins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Loretta Higgins accept?

Health plans from AmeriHealth Caritas Next list Loretta 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 Loretta Higgins was last updated on September 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.