DR. LUKE JAMES HIGGINS M.D., PH.D.
NPI 1316264328
Radiology - Diagnostic Radiology in Baltimore, MD

Active since April 29, 2010PECOS Enrolled
3001 S HANOVER ST, DEPT OF MEDICINE, BALTIMORE, MD 21225(410) 350-3565(410) 354-0186 Get Directions Write a Review

NPPES record last updated: April 27, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 27, 2026, Mar 13, 2026, Sep 16, 2025 and 2 more (5 updates tracked since 2016).

About Dr. Luke James Higgins M.d., Ph.d. NPPES

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

DR. LUKE JAMES HIGGINS M.D., PH.D. (NPI 1316264328) is an individual diagnostic radiology provider in Baltimore, Maryland, licensed in New Jersey (25MA12786200) and active in the NPI registry since April 2010. He is enrolled in Medicare PECOS, is affiliated with Cape Cod Hospital, and maintains 6 additional practice locations.

NPPES Registry Identity

NPI1316264328
Entity TypeIndividualMale
Primary Taxonomy2085R0202X
Provider Legal NameDR. LUKE JAMES HIGGINSCredential: M.D., PH.D.
Location Address3001 S HANOVER ST, DEPT OF MEDICINEBaltimore, MD 21225-1233
Mailing Address3600 Minnesota Dr Ste 800Edina, MN 55435-7915
Fax(410) 354-0186
Sole ProprietorNo
Medical School CMSStanford University School Of MedicineGraduated 2010
Enumeration DateApril 29, 2010
Last NPPES UpdateApril 27, 20265 updates tracked since enumeration
NPPES CertifiedApril 27, 2026
✔ NPI 1316264328 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Licenses✔ Licensed in NJ · 25MA12786200✔ Licensed in CT · 83026✔ Licensed in MA · 277384✔ Licensed in WV · 27076
Definition
A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
3001 S HANOVER ST, Baltimore, MD 21225

Secondary Practice Locations 6

Location 155 Lake Ave NWorcester, MA 01655-0002 · Phone (508) 334-3850
Location 268A Main StMedway, MA 02053-1775 · Phone (508) 488-3635
Location 314 Prospect StMilford, MA 01757-3003 · Phone (508) 473-1190 · Fax (508) 634-3687
Location 428 Crescent StMiddletown, CT 06457-3654 · Phone (860) 358-6000
Location 564 Robbins StWaterbury, CT 06708-2613 · Phone (203) 573-7124
Location 63600 Minnesota Dr Ste 800Minneapolis, MN 55435-7915 · Phone (952) 595-1100 · Fax (612) 294-4903

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Luke James Higgins M.d., Ph.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779732946
PECOS Enrollment IDI20181214000085, I20250821003221, I20260203003022
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

31

Medicare enrollment records show Luke Higgins reassigns Medicare billing to 31 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Diagnostic Radiology
100 N ACADEMY AVE
Danville, PA 17822
  • Reassigned Medicare billing, Massachusetts enrollment
  • 11 clinicians in this Medicare group
Diagnostic Radiology
1140 ROUTE 72 W
Manahawkin, NJ 08050
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2 clinicians in this Medicare group
Diagnostic Radiology
79 ROUTE 37 W, SUITE 103
Toms River, NJ 08755
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2 clinicians in this Medicare group
Family Medicine
68 SPRING STREET
Lock Haven, PA 17445
  • Reassigned Medicare billing, Massachusetts enrollment
  • 9 clinicians in this Medicare group
Emergency Medicine
94 OLD SHORT HILLS RD
Livingston, NJ 07039
  • Reassigned Medicare billing, New Jersey enrollment
  • 1,913 clinicians in this Medicare group
General Practice
300 CENTRAL AVE
East Orange, NJ 07018
  • Reassigned Medicare billing, New Jersey enrollment
  • 66 clinicians in this Medicare group
Diagnostic Radiology
703 MAIN ST
Paterson, NJ 07503
  • Reassigned Medicare billing, Massachusetts enrollment
  • 3 clinicians in this Medicare group
Diagnostic Radiology
718 TEANECK RD
Teaneck, NJ 07666
  • Reassigned Medicare billing, New Jersey enrollment
  • 47 clinicians in this Medicare group
General Practice
ONE OMEGA DRIVE, BUILDING 3, 2ND FLOOR
Stamford, CT 06907
  • Reassigned Medicare billing, Connecticut enrollment
  • 496 clinicians in this Medicare group
Diagnostic Radiology
2 W CRESCENT PARK
Warren, PA 16365
  • Reassigned Medicare billing, Massachusetts enrollment
  • 2 clinicians in this Medicare group

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 31

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.

Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes 99152
This procedure involves a doctor administering a medication to reduce your consciousness during a procedure. This helps in managing discomfort and anxiety. The initial application lasts for 15 minutes and is for individuals aged 5 years or older.
177 services151 patients
Ultrasonic guidance for blood vessel access 76937
Ultrasonic guidance for blood vessel access is a medical procedure where sound waves are used to create images of your blood vessels. This helps doctors to accurately locate and access the vessels for treatments or tests, ensuring safety and precision.
101 services78 patients
Insertion of tube into abdominal, pelvic, or leg artery, initial third order branch 36247
This procedure involves placing a tube into an artery in the abdomen, pelvis, or leg. The tube is inserted into the initial third order branch of the artery. This can help doctors diagnose or treat certain conditions by allowing access to these blood vessels.
65 services43 patients
Review by radiologist of additional artery image 75774
This procedure involves a radiologist examining an extra image of your artery. It's done to gain more insight into your vascular health. The radiologist will study the image to identify any abnormalities or issues that may need further medical attention.
61 services31 patients
Review by radiologist of abdominal artery image 75726
This procedure involves a radiologist examining an image of your abdominal artery. The goal is to identify any abnormalities or issues that might impact your health. It's a non-invasive method that provides valuable information about your body's circulatory system.
58 services37 patients
Ultrasound of both sides of head and neck blood flow 93880
An ultrasound of the head and neck blood flow is a safe, non-invasive procedure that uses sound waves to create images of blood vessels. It helps detect abnormalities like blockages or clots, ensuring optimal blood flow.
58 services58 patients

Hospital Affiliations CMS Care Compare 4

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

Cape Cod Hospital

Acute Care Hospitals · Hyannis, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220012
Location27 Park StreetHyannis, MA 02601 · Barnstable County
Emergency services Birthing friendly

Milford Regional Medical Center

Acute Care Hospitals · Milford, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number220090
Location14 Prospect StreetMilford, MA 01757 · Worcester County
Emergency services Birthing friendly

Shore Medical Center

Acute Care Hospitals · Somers Point, NJ
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number310047
Location100 Medical Center WaySomers Point, NJ 08244 · Atlantic County
Emergency services Birthing friendly

Ocean Medical Center

Acute Care Hospitals · Brick, NJ
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number310052
Location425 Jack Martin BlvdBrick, NJ 08724 · Ocean County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21225 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
$94.08 typical visit price
range $60.73 – $183.44
Typical copayment $23.52 (range $15.18 – $45.86)
Most-billed visit code 99203
Established Patient
$75.47 typical visit price
range $19.60 – $149.17
Typical copayment $18.86 (range $4.90 – $37.29)
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.

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.

Radiology (Diagnostic Radiology)
3001 S HANOVER ST, DEPT OF INTERNAL MEDICINE
BALTIMORE, MD 21225
Internal Medicine (Cardiovascular Disease)
3001 S HANOVER ST
BALTIMORE, MD 21225
Internal Medicine (Cardiovascular Disease)
3001 S HANOVER ST, NATIONAL INSTITUTE ON AGING, 5TH FLOOR OF HARBOR HOSP.
BALTIMORE, MD 21225
Durable Medical Equipment & Medical Supplies (Customized Equipment)
3001 S HANOVER ST, GRUEHN BUILDING SUITE 100
BALTIMORE, MD 21225
Specialist
3001 S HANOVER ST
BALTIMORE, MD 21225
Obstetrics & Gynecology
3001 S HANOVER ST, SUITE 301
BALTIMORE, MD 21225
Emergency Medicine
3001 S HANOVER ST
BALTIMORE, MD 21225
Orthopaedic Surgery (Orthopaedic Surgery of the Spine)
3001 S HANOVER ST, GRUEHN BLDG, STE 502
BALTIMORE, MD 21225

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 Luke Higgins's NPI number?

The NPI number for Luke Higgins is 1316264328. It was assigned to this individual provider in the NPPES registry on April 29, 2010.

Where is Luke Higgins located?

Luke Higgins practices at 3001 S Hanover St Dept Of Medicine, Baltimore, MD 21225. The listed phone number is (410) 350-3565.

What is Luke Higgins's specialty?

The primary specialty registered for this NPI is Radiology, specializing in Diagnostic Radiology, with taxonomy code 2085R0202X.

Is Luke Higgins enrolled in Medicare?

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

Which organizations bill Medicare for Luke Higgins's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Luke Higgins reassigns Medicare benefits to 31 organizations: Geisinger Clinic (Danville, PA), Coastal Imaging LLC (Manahawkin, NJ), Advanced Radiology Solutions (Toms River, NJ), Geisinger-Hm Joint Venture, LLC (Lock Haven, PA), Rwjbh Observation Associates LLC (Livingston, NJ) and 26 more organizations, listed in the Medicare section above. 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 Luke Higgins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Luke Higgins accept?

Health plans from Blue Cross and Blue Shield of Montana, CareSource, Mountain Health CO-OP, Oscar Insurance Company and Wellmark Health Plan of Iowa, Inc. list Luke 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 Luke Higgins affiliated with any hospitals?

According to CMS data, Luke Higgins is affiliated with Cape Cod Hospital, Milford Regional Medical Center, Shore Medical Center and Ocean Medical Center.

When was this NPI record last updated?

The NPPES record for Luke Higgins was last updated on April 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.