DR. PATRICK M. HIGGINS MD
NPI 1285642470
Ophthalmology in Bloomfield, NJ

Q: What is Patrick Higgins's NPI number?

The NPI number for Patrick Higgins is 1285642470. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Q: What is Patrick Higgins's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Patrick Higgins was last updated on June 9, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 03, 2006PECOS EnrolledAccepts Medicare Assignment

90.79/100

CMS Quality Rating

1255 BROAD ST, STE 104, BLOOMFIELD, NJ 07003(973) 707-5632(973) 707-7349 Get Directions Write a Review

NPPES record last updated: June 9, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 9, 2023, Mar 10, 2022, Oct 30, 2019 and 1 more (4 updates tracked since 2016).

On this page

About Dr. Patrick M. Higgins Md NPPES

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

DR. PATRICK M. HIGGINS MD (NPI 1285642470) is an individual ophthalmology provider in Bloomfield, New Jersey, licensed in New Jersey (25MA06558600) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with Clara Maass Medical Center, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1285642470

Entity TypeIndividualMale

Primary Taxonomy207W00000X

Provider Legal NameDR. PATRICK M. HIGGINSCredential: MD

Location Address1255 BROAD ST, STE 104Bloomfield, NJ 07003-3000

Mailing Address1 Corporate DrWayne, NJ 07470-3112 · (973) 987-3380 · Fax (973) 707-7349

Phone(973) 707-5632

Fax(973) 707-7349

Sole ProprietorYes

Medical School CMSOtherGraduated 1993

Enumeration DateAugust 3, 2006

Last NPPES UpdateJune 9, 20234 updates tracked since enumeration

NPPES CertifiedJune 9, 2023

✔ NPI 1285642470 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians

Taxonomy Code207W00000X

License✔ Licensed in NJ · 25MA06558600

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.

1255 BROAD ST, Bloomfield, NJ 07003

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Secondary Practice Locations 5

Location 11095 Morris Ave Ste 103AUnion, NJ 07083-7170 · Phone (908) 312-1001 · Fax (908) 312-1005

Location 26121 Kennedy BlvdNorth Bergen, NJ 07047-3483 · Phone (201) 766-5151

Location 3500 N Franklin Tpke Ste 205Ramsey, NJ 07446-1160 · Phone (201) 962-9396 · Fax (201) 474-7048

Location 41086 Teaneck Rd Ste 2ATeaneck, NJ 07666-4858 · Phone (201) 871-3414 · Fax (201) 871-4830

Location 51 Corporate DrWayne, NJ 07470-3112 · Phone (973) 987-3380 · Fax (973) 987-3379

Other Identifiers 1

Medicaid8255105NJ

Accepted Insurance

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

Dr. Patrick M. 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 ID6507882107

PECOS Enrollment IDI20070628000201, I20231030000788

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 18

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.

Injection, faricimab-svoa, 0.1 mg J2777

Faricimab-svoa is a medication given through an injection into the eye to treat certain eye conditions. The 0.1 mg dosage helps control disease progression, improving vision and eye health. The procedure is done by a healthcare professional.

30,301 services99 patients

Imaging of retina 92134

Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.

1,444 services580 patients

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.

1,302 services537 patients

Injection of drug into eye 67028

An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.

862 services170 patients

Extended exam of the back part of the eye with optic nerve drawing 92202

This procedure involves a detailed examination of the back part of your eye, focusing on the optic nerve, a crucial component for vision. A drawing or map of the optic nerve is created to help track any changes over time. This can help detect eye diseases early.

603 services346 patients

Injection, ranibizumab, 0.1 mg J2778

Ranibizumab is a medication given via injection to treat certain eye conditions like age-related macular degeneration. It works by slowing vision loss and in some cases, improving vision by blocking abnormal blood vessel growth in the eye.

446 services29 patients

Extended exam of the back part of the eye with retinal drawing 92201

This procedure involves a detailed examination of the back part of your eye, including the retina. It helps identify any abnormalities or issues. A retinal drawing is made to record findings. It's non-invasive and crucial for maintaining eye health.

274 services208 patients

Established patient problem focused exam of visual system 92012

This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.

273 services137 patients

Exam of retinal blood vessels using a special camera after injection of a dye 92235

This procedure, known as a fluorescein angiography, involves taking images of the back of your eye. A dye is injected into your arm that travels to your eye, highlighting the blood vessels in your retina. This helps identify any abnormalities.

187 services157 patients

Imaging of front third of eye using a special camera after injection of a dye 92287

This procedure involves capturing images of the front part of your eye. A special camera is used for this purpose. Prior to the imaging, a dye is injected to highlight the structures of the eye. This helps in better diagnosis and treatment planning.

107 services91 patients

Injection, aflibercept, 1 mg J0178

Aflibercept injection is a treatment for certain eye conditions that affect vision. It works by blocking abnormal blood vessel growth and leakage in the eye, which can cause vision loss. The medication is administered directly into the eye by a healthcare professional.

98 services20 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

73 services54 patients

New patient complete exam of visual system 92004

A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.

49 services49 patients

2d ultrasound scan of eye tissue and structures 76512

A 2D ultrasound scan of eye tissue and structures is a non-invasive procedure that uses sound waves to create images of your eye. It helps doctors to examine your eye's internal structures, detect abnormalities, and plan for treatments if needed.

44 services25 patients

Compounded drug, not otherwise classified J7999

A compounded drug is a personalized medication created to meet unique patient needs. If you can't take standard drugs due to allergies or need a specific dosage not commercially available, a pharmacist can mix ingredients to make a drug specifically for you.

43 services31 patients

Photography of the retina 92250

Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.

39 services36 patients

Exam of visual field with extended testing 92083

An extended visual field exam is a detailed test to evaluate your peripheral (side) vision. It helps to detect any potential blind spots which may not be noticeable in daily life. These could be caused by eye diseases like glaucoma, or neurological conditions.

23 services18 patients

Removal of membrane of retina 67041

Removal of the retina's membrane is a surgical procedure aimed at treating eye conditions affecting the retina's function. It involves a delicate operation to eliminate scar tissue or membranes causing vision problems. The procedure can help improve or stabilize vision.

22 services22 patients

Hospital Affiliations CMS Care Compare 3

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

Clara Maass Medical Center

Acute Care Hospitals · Belleville, NJ

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310009

LocationOne Clara Maass DriveBelleville, NJ 07109 · Essex County

Emergency services Birthing friendly

Englewood Hospital And Medical Center

Acute Care Hospitals · Englewood, NJ

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number310045

Location350 Engle StEnglewood, NJ 07631 · Bergen County

Emergency services Birthing friendly

Good Samaritan Hospital Of Suffern

Acute Care Hospitals · Suffern, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number330158

Location255 Lafayette AvenueSuffern, NY 10901 · Rockland County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 07003 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

$144.86 typical visit price

range $63.84 – $190.92

Typical copayment $36.21 (range $15.96 – $47.73)

Most-billed visit code 99204

Established Patient

$79.09 typical visit price

range $20.97 – $155.92

Typical copayment $19.77 (range $5.24 – $38.98)

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.

90.79/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

99.51

Promoting Interoperability

100

Improvement Activities

Cost

69.8

Reported Quality Measures

Diabetes: Eye Exam

Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period

100%214 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%258 patients5/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

SANDRA ROBBINS OD

Optometrist

1255 BROAD ST
BLOOMFIELD, NJ 07003

Essex County (973) 338-7575

DENISE FURES OD

Optometrist

1255 BROAD ST
BLOOMFIELD, NJ 07003

Essex County (973) 338-7575

MARIA TURIZO MD

Pediatrics

1255 BROAD ST, SUITE 105
BLOOMFIELD, NJ 07003

Essex County (973) 233-5494

NITI MISTRY OD

Optometrist

1255 BROAD ST
BLOOMFIELD, NJ 07003

Essex County (973) 338-7575

MRS. GINA M BARRA MA, LPC

Counselor (Professional)

1255 BROAD ST, SUITE 204
BLOOMFIELD, NJ 07003

Essex County (973) 771-9000

MR. JOSE PEREZ MA, LMFT

Counselor (Mental Health)

1255 BROAD ST, SUITE 204
BLOOMFIELD, NJ 07003

Essex County (973) 771-9000

BLOOMFIELD SPINE & REHABILITATION

Chiropractor (Rehabilitation)

1255 BROAD ST, SUITE 207
BLOOMFIELD, NJ 07003

Essex County (973) 233-7104

AFFORDABLE CARE EYE PHYSICIAN NETWORK

Ophthalmology

1255 BROAD ST, STE 104
BLOOMFIELD, NJ 07003

Essex County (973) 707-5632

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 Patrick Higgins's NPI number?

The NPI number for Patrick Higgins is 1285642470. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Patrick Higgins located?

Patrick Higgins practices at 1255 Broad St Ste 104, Bloomfield, NJ 07003. The listed phone number is (973) 707-5632.

What is Patrick Higgins's specialty?

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

Is Patrick Higgins enrolled in Medicare?

Yes. Patrick 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 Patrick Higgins accept?

Health plans from Ambetter Health and Ambetter Health of Delaware list Patrick 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.

Is Patrick Higgins affiliated with any hospitals?

According to CMS data, Patrick Higgins is affiliated with Clara Maass Medical Center, Englewood Hospital And Medical Center and Good Samaritan Hospital Of Suffern.

When was this NPI record last updated?

The NPPES record for Patrick Higgins was last updated on June 9, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.