LISA K HIGGINBOTHAM MD
NPI 1356394076
Internal Medicine in Waynesboro, PA

Q: What is Lisa Higginbotham's NPI number?

The NPI number for Lisa Higginbotham is 1356394076. It was assigned to this individual provider in the NPPES registry on May 17, 2006.

Q: What is Lisa Higginbotham's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Lisa Higginbotham was last updated on July 15, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 May 17, 2006PECOS EnrolledAccepts Medicare Assignment

601 E MAIN ST, LEVEL 3, WAYNESBORO, PA 17268(717) 765-5087(717) 765-5070 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 15, 2024, Apr 12, 2021, Dec 5, 2019 and 1 more (4 updates tracked since 2017).

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About Lisa K Higginbotham Md NPPES

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

LISA K HIGGINBOTHAM MD (NPI 1356394076) is an individual internal medicine provider in Waynesboro, Pennsylvania, licensed in Pennsylvania (MD453969) and active in the NPI registry since May 2006. She is enrolled in Medicare PECOS, is affiliated with Gettysburg Hospital, and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1356394076

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameLISA K HIGGINBOTHAMCredential: MD

Location Address601 E MAIN ST, LEVEL 3Waynesboro, PA 17268-2332

Mailing Address601 Memory LnYork, PA 17402-2231 · (717) 851-1405

Phone(717) 765-5087

Fax(717) 765-5070

Sole ProprietorNo

Medical School CMSUniversity Of Minnesota Medical SchoolGraduated 1995

Enumeration DateMay 17, 2006

Last NPPES UpdateJuly 15, 20244 updates tracked since enumeration

NPPES CertifiedJuly 15, 2024

✔ NPI 1356394076 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in PA · MD453969

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

601 E MAIN ST, Waynesboro, PA 17268

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Secondary Practice Locations 4

Location 1601 E Main StWaynesboro, PA 17268-2332 · Phone (717) 765-5085 · Fax (717) 765-5066

Location 22075 Scotland AveChambersburg, PA 17201-1451 · Phone (717) 217-6055 · Fax (717) 217-4329

Location 31425 Philadelphia AveChambersburg, PA 17201-1386 · Phone (717) 217-6055 · Fax (717) 217-4329

Location 42055 Scotland AveChambersburg, PA 17201-1451 · Phone (717) 217-6056 · Fax (717) 217-4329

Other Identifiers 5

Other61131403 S108NEMD · Carefirst Blue Shield

Medicaid904001300MD

OtherF288 0008Ghmsi

OtherP00026790MD · Railroad Medicare

Medicaid103054240PA

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Lisa K Higginbotham 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 ID7214023654

PECOS Enrollment IDI20151009000020

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

Medicare enrollment records show Lisa Higginbotham reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wellspan Medical Group

Same address

Family Medicine

601 E MAIN ST
Waynesboro, PA 17268

Reassigned Medicare billing, Pennsylvania enrollment
3,080 clinicians in this Medicare group

NPI 1053024778 (717) 765-5085

Good Samaritan Physician Services

15 mi

Internal Medicine

2055 SCOTLAND AVE
Chambersburg, PA 17201

Reassigned Medicare billing, Pennsylvania enrollment
143 clinicians in this Medicare group

NPI 1316713647 (717) 217-4253

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 17

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.

1,114 services610 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.

359 services262 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

206 services203 patients

Influenza vaccine split virus, preservative free 90662

The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.

201 services199 patients

Detection test by immunoassay with direct visual observation for influenza virus 87804

This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.

78 services37 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

56 services12 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

50 services50 patients

Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426

An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.

39 services36 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

36 services36 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.

33 services33 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

32 services32 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

32 services32 patients

Urinalysis, manual test 81002

A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.

18 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

15 services15 patients

Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit G0438

An annual wellness visit is a yearly appointment with your doctor to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's an opportunity to discuss your health status and goals and get a plan tailored for you.

15 services15 patients

Administration of vaccine 90471

Administering a vaccine involves injecting a small, safe piece of a virus or bacteria into your body. This triggers your immune system to recognize and fight off the disease in the future. It's a vital tool in preventing serious illnesses and maintaining public health.

13 services12 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

12 services11 patients

Hospital Affiliations CMS Care Compare 3

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

Gettysburg Hospital

Acute Care Hospitals · Gettysburg, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390065

Location147 Gettys StreetGettysburg, PA 17325 · Adams County

Emergency services Birthing friendly

Wellspan Waynesboro Hospital

Acute Care Hospitals · Waynesboro, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390138

Location501 East Main StWaynesboro, PA 17268 · Franklin County

Emergency services

Wellspan Chambersburg Hospital

Acute Care Hospitals · Chambersburg, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390151

Location112 North Seventh StreetChambersburg, PA 17201 · Franklin County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 17268 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

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$96.82 typical visit price

range $17.33 – $135.84

Typical copayment $24.20 (range $4.33 – $33.96)

Most-billed visit code 99214

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.

Reported Quality Measures

Urinary Incontinence: Assessment of Presence or Absence of Urinary Incontinence in Women Aged 65 Years and Older

Percentage of female patients aged 65 years and older who were assessed for the presence or absence of urinary incontinence within 12 months

100%231 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.

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.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

34 suppliers121 claims290 services$5.85 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

18 suppliers31 claims35 services$0.94 avg. paid by Medicare

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431

DME-Oxygen and Supplies · category DC000N

1 supplier11 claims11 services$17.18 avg. paid by Medicare

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers18 claims18 services$89.47 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

MATTHEW C PAULI D.O.

Physical Medicine & Rehabilitation