KELVIN D HIGA MD
NPI 1356304224
Surgery in Fresno, CA

Q: What is Kelvin Higa's NPI number?

The NPI number for Kelvin Higa is 1356304224. It was assigned to this individual provider in the NPPES registry on April 10, 2006.

Q: What is Kelvin Higa's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Q: When was this NPI record last updated?

The NPPES record for Kelvin Higa was last updated on June 25, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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 April 10, 2006PECOS EnrolledAccepts Medicare Assignment

85.78/100

CMS Quality Rating

205 E RIVER PARK CIR, SUITE 460, FRESNO, CA 93720(559) 261-4500(559) 261-4501 Get Directions Write a Review

NPPES record last updated: June 25, 2014. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Kelvin D Higa Md NPPES

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

KELVIN D HIGA MD (NPI 1356304224) is an individual surgery provider in Fresno, California, licensed in California (G53771) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Geffen School Of Medicine (1983).

NPPES Registry Identity

NPI1356304224

Entity TypeIndividualMale

Primary Taxonomy208600000X

Provider Legal NameKELVIN D HIGACredential: MD

Location Address205 E RIVER PARK CIR, SUITE 460Fresno, CA 93720-1571

Mailing AddressPo Box 28947Fresno, CA 93729-8947 · (559) 261-4500 · Fax (559) 261-4501

Phone(559) 261-4500

Fax(559) 261-4501

Sole ProprietorNo

Medical School CMSUniversity Of California, Geffen School Of MedicineGraduated 1983

Enumeration DateApril 10, 2006

Last NPPES UpdateJune 25, 2014

✔ NPI 1356304224 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

License✔ Licensed in CA · G53771

Definition

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X · License G53771 (CA)

205 E RIVER PARK CIR, Fresno, CA 93720

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Other Identifiers 1

Medicare UPINE57844CA

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

Kelvin D Higa 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 ID6103895859

PECOS Enrollment IDI20080122000388

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 7

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 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.

212 services152 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

56 services56 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

25 services25 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

18 services18 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.

17 services17 patients

Repair of hernia of muscle at esophagus and stomach using an endoscope 43281

This procedure fixes a hernia, an area where your stomach and esophagus muscles have weakened. Using an endoscope, a thin tube with a camera, the doctor can see and repair the hernia without large incisions, promoting quicker recovery.

16 services16 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 93720 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

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$73.16 typical visit price

range $19.28 – $144.60

Typical copayment $18.29 (range $4.82 – $36.15)

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.

85.78/100

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

Scored as part of a group practice

Quality

91.3

Promoting Interoperability

100

Improvement Activities

Cost

61.3

Referred Medical Equipment & Supplies CMS DME claims 5

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

Parenteral nutrition solution, not otherwise specified, 10 grams lipids B4185