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MR. STEPHEN E HIGGINS MD
NPI 1235104845
Ophthalmology in Portage, MI

Active since February 18, 2006PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
3142 W CENTRE AVE, PORTAGE, MI 49024(269) 329-5870(269) 329-5865 Get Directions Write a Review

NPPES record last updated: November 17, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Stephen E Higgins Md NPPES

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

MR. STEPHEN E HIGGINS MD (NPI 1235104845) is an individual ophthalmology provider in Portage, Michigan, licensed in Michigan (4301405954) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Michigan Medical School (1985).

NPPES Registry Identity

NPI1235104845
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameMR. STEPHEN E HIGGINSCredential: MD
Location Address3142 W CENTRE AVEPortage, MI 49024-4860
Mailing Address3142 W Centre AvePortage, MI 49024-4860 · (269) 329-5870 · Fax (269) 329-5865
Phone(269) 329-5870
Fax(269) 329-5865
Sole ProprietorNo
Medical School CMSUniversity Of Michigan Medical SchoolGraduated 1985
Enumeration DateFebruary 18, 2006
Last NPPES UpdateNovember 17, 2022
NPPES CertifiedNovember 17, 2022
✔ NPI 1235104845 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
License✔ Licensed in MI · 4301405954
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
3142 W CENTRE AVE, Portage, MI 49024
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Other Identifiers 1

Medicaid2669516MI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Priority Health, UnitedHealthcare.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

Mr. Stephen E Higgins Md 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 ID9739133364
PECOS Enrollment IDI20120222000458
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 14

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 complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
368 services362 patients
Removal of cataract with insertion of prosthetic lens 66984
This is a procedure where a cloudy lens in your eye, known as a cataract, is removed. After removal, a clear artificial lens is inserted. This helps to restore your vision, enabling you to see clearly again.
206 services127 patients
Measurement of corneal curvature and depth of eye 92136
This procedure measures the shape and depth of your eye, specifically the cornea, the clear front surface. It helps in diagnosing conditions, planning for surgeries, or fitting contact lenses. It's non-invasive and painless.
191 services123 patients
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.
180 services133 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.
124 services118 patients
Imaging of optic nerve 92133
Imaging of the optic nerve is a non-invasive procedure that captures detailed pictures of your optic nerve. It helps doctors assess eye health, particularly for conditions like glaucoma. It's painless, quick, and uses safe technology like MRI or OCT (Optical Coherence Tomography).
101 services97 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49024 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
$126.15 typical visit price
range $54.34 – $166.68
Typical copayment $31.53 (range $13.58 – $41.67)
Most-billed visit code 99204
Established Patient
$68.07 typical visit price
range $17.09 – $135.40
Typical copayment $17.01 (range $4.27 – $33.85)
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.

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.

100/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality100
Improvement Activities40
Cost100

Referred Medical Equipment & Supplies CMS DME claims 4

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

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers31 claims31 services$58.01 avg. paid by Medicare
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens V2203
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers15 claims24 services$42.81 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims14 services$59.49 avg. paid by Medicare
Spherocylinder, trifocal, plano to plus or minus 4.00d sphere, .12-2.00d cylinder, per lens V2303
Other-Vision, Hearing, and Speech Services · category OC000N
2 suppliers27 claims46 services$54.57 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Stephen Higgins's NPI number?

The NPI number for Stephen Higgins is 1235104845. It was assigned to this individual provider in the NPPES registry on February 18, 2006.

Where is Stephen Higgins located?

Stephen Higgins practices at 3142 W Centre Ave, Portage, MI 49024. The listed phone number is (269) 329-5870.

What is Stephen Higgins's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Stephen Higgins enrolled in Medicare?

Yes. Stephen Higgins 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 Stephen Higgins accept?

Health plans from Priority Health and UnitedHealthcare list Stephen 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 Stephen Higgins was last updated on November 17, 2022. 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.