TOMAS RAFAEL HIGGINS
NPI 1225761216
Internal Medicine in Madisonville, KY

Q: What is Tomas Higgins's NPI number?

The NPI number for Tomas Higgins is 1225761216. It was assigned to this individual provider in the NPPES registry on July 6, 2022.

Q: What is Tomas Higgins's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Tomas Higgins was last updated on July 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since July 06, 2022PECOS EnrolledAccepts Medicare Assignment

900 HOSPITAL DR, MADISONVILLE, KY 42431(270) 825-5100 Get Directions Write a Review

NPPES record last updated: July 6, 2022. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Tomas Rafael Higgins NPPES

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

TOMAS RAFAEL HIGGINS (NPI 1225761216) is an individual internal medicine provider in Madisonville, Kentucky, licensed in Kentucky (TP823) and active in the NPI registry since July 2022. He is enrolled in Medicare PECOS, is affiliated with Deaconess Hospital Inc, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1225761216

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameTOMAS RAFAEL HIGGINS

Location Address900 HOSPITAL DRMadisonville, KY 42431-1644

Mailing Address13713 Sw 50th StMiramar, FL 33027-5912

Phone(270) 825-5100

Sole ProprietorNo

Medical School CMSOtherGraduated 1999

Enumeration DateJuly 6, 2022

NPPES CertifiedJuly 6, 2022

✔ NPI 1225761216 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in KY · TP823

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

900 HOSPITAL DR, Madisonville, KY 42431

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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

Tomas Rafael Higgins 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 ID1850773821

PECOS Enrollment IDI20220808001767

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.

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.

526 services216 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.

215 services112 patients

Hospital discharge day management, 30 minutes or less 99238

Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.

136 services131 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.

117 services108 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

105 services57 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

57 services56 patients

Hospital Affiliations CMS Care Compare 4

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

Deaconess Hospital Inc

Acute Care Hospitals · Evansville, IN

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number150082

Location600 Mary StEvansville, IN 47710 · Vanderburgh County

Emergency services

Owensboro Health Muhlenberg Community Hospital

Acute Care Hospitals · Greenville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180004

Location440 Hopkinsville StreetGreenville, KY 42345 · Muhlenberg County

Emergency services

Jennie Stuart Medical Center

Acute Care Hospitals · Hopkinsville, KY

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180051

Location320 West 18th StreetHopkinsville, KY 42240 · Christian County

Emergency services Birthing friendly

Baptist Health Deaconess Madisonville

Acute Care Hospitals · Madisonville, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180093

Location900 Hospital DriveMadisonville, KY 42431 · Hopkins County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 42431 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$93.94 typical visit price

range $16.53 – $131.99

Typical copayment $23.48 (range $4.13 – $32.99)

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 20

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

CADE CUNNINGHAM

Pharmacist