DR. LUKE JAMES HIGGINS M.D., PH.D.
NPI 1316264328
Radiology - Diagnostic Radiology in Baltimore, MD
NPI Status: Active since April 29, 2010
Contact Information
3001 S HANOVER ST
DEPT OF MEDICINE
BALTIMORE, MD
ZIP 21225
Phone: (410) 350-3565
Fax: (410) 354-0186
- Individual
- Male
- Years of Experience 17
- Radiology
- Diagnostic Radiology
- Accepts Insurance
- May Accept Medicare Approved Payment
- PECOS Enrolled
About LUKE HIGGINS
This page provides the complete NPI Profile along with additional information for Luke Higgins, a provider established in Baltimore, Maryland with a medical specialization in Radiology, focusing in diagnostic radiology and more than 17 years of experience. He graduated from Stanford University School Of Medicine in 2010. The healthcare provider is registered in the NPI registry with number 1316264328 assigned on April 2010. The practitioner's primary taxonomy code is 2085R0202X with license number 25MA12786200 (NJ). The provider is registered as an individual and his NPI record was last updated April 2026.
- NPI
- 1316264328
- Provider Name
- DR. LUKE JAMES HIGGINS M.D., PH.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3001 S HANOVER ST DEPT OF MEDICINE BALTIMORE, MD 21225
- Location Phone
- (410) 350-3565
- Location Fax
- (410) 354-0186
- Mailing Address
- 3600 MINNESOTA DR STE 800 EDINA, MN 55435
- Medical School Name
- STANFORD UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2010
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-29-2010
- Last Update Date
- 04-27-2026
- Code Navigator
Location Map
Secondary Locations
- 14 Prospect St
Milford, MA 01757
(508) 473-1190 - 64 Robbins St
Waterbury, CT 06708
(203) 573-7124 - 3600 Minnesota Dr Ste 800
Minneapolis, MN 55435
(952) 595-1100 - 55 Lake Ave N
Worcester, MA 01655
(508) 334-3850 - 28 Crescent St
Middletown, CT 06457
(860) 358-6000 - 68A Main St
Medway, MA 02053
(508) 488-3635
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Radiology Diagnostic Radiology
- Taxonomy Code
- 2085R0202X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 25MA12786200
- License State
- NJ
- Taxonomy Description
- A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | 83026 (CT) |
| 2 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | 277384 (MA) |
| 3 | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | 27076 (WV) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Preferred Bronze PPO? 201 - PPO
- Blue Preferred Bronze PPO? 202 - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? 204 - PPO
- Blue Preferred Gold PPO? 901 - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? 203 - PPO
- Blue Preferred Silver PPO? 308 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Peak PPO Bronze HDHP - PPO
- Peak PPO Bronze Standard - PPO
- Peak PPO Catastrophic - PPO
- Peak PPO Gold - PPO
- Peak PPO Gold Standard - PPO
- Peak PPO Silver - PPO
- Peak PPO Silver Standard - PPO
- Plus Bronze - PPO
- Plus Bronze Standard - PPO
- Plus Gold - PPO
- Plus Gold Standard - PPO
- Plus Silver Standard - PPO
- Rocky Mountain Bronze Standard - PPO
- Rocky Mountain Gold Standard - PPO
- Rocky Mountain Silver Standard - PPO
- PEAK PPO BRONZE - PPO
- PEAK PPO BRONZE HDHP - PPO
- PEAK PPO GOLD - PPO
- PEAK PPO GOLD HDHP - PPO
- PEAK PPO SILVER - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Luke Higgins is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Luke Higgins is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 3779732946
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20181214000085, I20260203003022
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Aspiration of fluid from chest cavity using imaging guidance
Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts
Complete ultrasound study of arm and leg arteries
Ct scan head or brain without contrast
Ct scan of abdomen and pelvis with contrast
Ct scan of abdomen and pelvis without contrast
Ct scan of abdominal aorta and both leg arteries with contrast
Ct scan of blood vessels of abdomen and pelvis with contrast
Ct scan of blood vessels of chest with contrast
Ct scan of chest without contrast
Ct scan of upper spine without contrast
Drainage of fluid from abdominal cavity using imaging guidance
Fine needle aspiration biopsy using ultrasound guidance, first growth
Fluoroscopic guidance for insertion or removal of central vein access device
Insertion of central venous tube with port (5 years or older)
Insertion of non-tunneled central venous tube for infusion (5 years or older)
Insertion of tunneled central venous tube for infusion (5 years or older)
Needle biopsy of liver through skin
Review by radiologist of ct guidance for needle placement
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes
Ultrasonic guidance for blood vessel access
Ultrasonic guidance for needle placement
Ultrasound of both sides of head and neck blood flow
Ultrasound scan of abdominal aorta
Ultrasound study of arm and leg arteries
Ultrasound study of arm or leg veins with compression and maneuvers
Ultrasound study of one arm or leg veins with compression and maneuvers
Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes
X-ray of chest, 1 view
X-ray of chest, 2 views
X-ray of foot, minimum of 3 views
X-ray of hand, minimum of 3 views
X-ray of shoulder, minimum of 2 views
X-ray of wrist, minimum of 3 views
This procedure, known as a thoracentesis, involves removing fluid from the space between the lungs and chest wall, called the pleural space. It's performed under imaging guidance to ensure precision. It can help diagnose conditions or relieve symptoms like shortness of breath.
This service was performed 41 times for 36 patientsThis procedure involves using sound waves to create images of your aorta, vena cava, groin vessels, or bypass grafts. It helps to detect abnormalities or blockages, ensuring your blood flows smoothly. It's painless and non-invasive.
This service was performed 13 times for 13 patientsThis procedure involves using sound waves to produce images of your arm and leg arteries. It helps identify blockages or abnormalities that could lead to conditions like stroke or peripheral artery disease. It's non-invasive and painless.
This service was performed 27 times for 27 patientsA CT scan of the head or brain without contrast is a non-invasive imaging procedure. It uses X-rays to create detailed pictures of your brain, skull, and other structures inside your head. It helps to detect conditions like strokes, tumors, or injuries. No dye (contrast) is used in this test.
This service was performed 68 times for 66 patientsA CT scan of the abdomen and pelvis with contrast is an imaging procedure. A special dye, called contrast, is used to make certain areas more visible. This can help identify issues such as infections, tumors, or other abnormalities. The procedure is painless and usually takes about 30 minutes.
This service was performed 40 times for 40 patientsA CT scan of the abdomen and pelvis is a non-invasive medical test. It uses special X-ray equipment to create detailed images of your abdominal and pelvic areas. This helps doctors examine organs, tissues, and vessels. No contrast dye is used in this procedure.
This service was performed 15 times for 15 patientsA CT scan of the abdominal aorta and both leg arteries with contrast is a medical imaging procedure. A special dye is injected to make your blood vessels visible on the scan. This helps to check for any blockages or abnormalities in these areas.
This service was performed 21 times for 21 patientsA CT scan of the abdomen and pelvis with contrast is a medical imaging procedure. A special dye, called contrast, is used to make blood vessels more visible. The scan produces detailed images of your abdomen and pelvis, helping doctors to diagnose conditions or plan treatments.
This service was performed 12 times for 12 patientsA CT scan of the chest with contrast is a non-invasive imaging test. It uses X-rays and a special dye to get detailed images of your blood vessels in the chest. This helps in diagnosing conditions related to heart and lungs.
This service was performed 23 times for 23 patientsA CT scan of the chest without contrast is a non-invasive imaging procedure. It uses special X-ray equipment to produce detailed images of your chest area, including your lungs and heart. It can help diagnose conditions such as lung diseases or heart disorders. It doesn't involve any dyes or contrast agents.
This service was performed 36 times for 36 patientsA CT scan of the upper spine without contrast is a non-invasive imaging test that uses X-rays to capture detailed images of your neck and upper back. It helps in identifying issues like fractures, tumors, or infections. No dye (contrast) is used in this scan.
This service was performed 31 times for 31 patientsThis procedure involves removing excess fluid from your abdominal cavity, which can relieve discomfort. A specialist uses imaging technology to guide a thin needle into the right spot. The fluid is then drained out safely.
This service was performed 25 times for 14 patientsFine needle aspiration biopsy with ultrasound guidance is a procedure where a thin needle is inserted into a growth to extract a small sample. Ultrasound helps accurately locate the growth. This sample is then analyzed to determine the nature of the growth.
This service was performed 11 times for 11 patientsFluoroscopic guidance for central vein access device insertion or removal is a procedure where a special X-ray, called a fluoroscope, is used to help accurately place or remove a device in a central vein. This device aids in delivering medications or collecting blood samples.
This service was performed 50 times for 48 patientsA central venous tube with port is a small, flexible tube inserted into a large vein, usually in the chest. It allows for easy administration of medication, fluids, or blood products over a long period. A port is attached under the skin for easy access. It's safe for individuals aged 5 and above.
This service was performed 22 times for 21 patientsThis procedure involves placing a thin tube into a large vein, usually in the neck or chest, to administer medication or fluids. It's done under local anesthesia to minimize discomfort. It's a standard, safe procedure for individuals aged 5 and above.
This service was performed 19 times for 19 patientsThe insertion of a tunneled central venous tube is a procedure where a thin, flexible tube is placed into a large vein, usually in the neck or chest. This tube allows healthcare providers to give medications, fluids, or nutrients directly into your bloodstream over a longer period.
This service was performed 15 times for 15 patientsA needle biopsy of the liver through skin is a procedure where a small tissue sample from your liver is collected using a thin needle. This is done to diagnose liver diseases or conditions. It involves inserting the needle through your skin and into your liver.
This service was performed 14 times for 14 patientsThis process involves a radiologist examining CT scan images to accurately guide a needle's placement within the body. This technique is often used for biopsies or treatments, ensuring precision and safety.
This service was performed 21 times for 20 patientsFollow-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.
This service was performed 26 times for 22 patientsUltrasonic 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.
This service was performed 87 times for 75 patientsUltrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.
This service was performed 20 times for 20 patientsAn 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.
This service was performed 97 times for 97 patientsAn ultrasound scan of the abdominal aorta is a non-invasive imaging test. It uses sound waves to create pictures of the main blood vessel in your abdomen, the aorta, to check its size and shape. This helps detect any abnormalities or issues early.
This service was performed 27 times for 27 patientsAn ultrasound study of arm and leg arteries is a non-invasive procedure that uses sound waves to create images of your arteries. It helps in checking blood flow, identifying blockages, or detecting other abnormalities in your arteries.
This service was performed 13 times for 13 patientsAn ultrasound study of arm or leg veins with compression and maneuvers is a non-invasive procedure that uses sound waves to create images of your veins. This helps identify blood clots or other vein problems. During the procedure, pressure is applied to the veins and certain movements are performed to assess blood flow.
This service was performed 17 times for 17 patientsThis is a non-invasive procedure using sound waves to visualize veins in an arm or leg. It involves applying gentle pressure and performing certain movements. It helps identify any abnormal blood flow or clots, ensuring vascular health.
This service was performed 24 times for 24 patientsThis 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.
This service was performed 122 times for 109 patientsA chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
This service was performed 52 times for 49 patientsA chest X-ray, 2 views, is a quick, painless test that creates pictures of the structures inside your chest, such as your heart, lungs, and blood vessels. Two different angles are used to get a comprehensive view. This helps in diagnosing conditions like pneumonia, heart problems, or lung cancer.
This service was performed 97 times for 97 patientsAn X-ray of the foot, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones and tissues in your foot. This helps to identify fractures, infections, or other abnormalities. Multiple views ensure a comprehensive examination.
This service was performed 23 times for 23 patientsAn X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.
This service was performed 13 times for 13 patientsAn X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
This service was performed 18 times for 18 patientsAn X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.
This service was performed 11 times for 11 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 21225 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $94.08
- Minimum New Patient Price $60.73
- Maximum New Patient Price $183.44
- Average New Patient Copayment $23.52
- Minimum New Patient Copayment $15.18
- Maximum New Patient Copayment $45.86
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $75.47
- Minimum Established Patient Price $19.6
- Maximum Established Patient Price $149.17
- Average Established Patient Copayment $18.86
- Minimum Established Patient Copayment $4.9
- Maximum Established Patient Copayment $37.29
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Luke Higgins is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| THE MEDICAL CENTER (BOWLING GREEN) | 250 PARK STREET BOWLING GREEN, KY 42101 | (270) 745-1000 | Acute Care Hospitals | |
| CAPE COD HOSPITAL | 27 PARK STREET HYANNIS, MA 02601 | (508) 771-1800 | Acute Care Hospitals | |
| MILFORD REGIONAL MEDICAL CENTER | 14 PROSPECT STREET MILFORD, MA 01757 | (508) 473-1190 | Acute Care Hospitals | |
| FALMOUTH HOSPITAL | 67 & 100 TER HEUN DRIVE FALMOUTH, MA 02540 | (508) 548-5300 | Acute Care Hospitals | |
| OCEAN MEDICAL CENTER | 425 JACK MARTIN BLVD BRICK, NJ 08724 | (732) 840-2200 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1316264328, we treat the final digit (8) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 62. The final step is to find the difference between that total and the next multiple of ten (70 - 62 = 8).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 62 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
BALTIMORE, MD 21225
BALTIMORE, MD 21225
BALTIMORE, MD 21225
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316264328, enumerated as an "individual" on April 29, 2010.
The provider is located at 3001 S HANOVER ST DEPT OF MEDICINE BALTIMORE, MD 21225 and the phone number is (410) 350-3565.
Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana and Mountain. Please consult your insurance carrier or call the provider to verify.
Luke Higgins is affiliated with: THE MEDICAL CENTER (BOWLING GREEN), CAPE COD HOSPITAL, MILFORD REGIONAL MEDICAL CENTER, FALMOUTH HOSPITAL and OCEAN MEDICAL CENTER.