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DR. MARIA E HIGGINS O.D.
NPI 1376514018
Optometrist in West Chester, PA

Active since January 31, 2006PECOS EnrolledAccepts Medicare Assignment
88.33/100
CMS Quality Rating
422 COLLEGE AVE, WEST CHESTER, PA 19382(412) 260-4103 Get Directions Write a Review

NPPES record last updated: June 11, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 11, 2021, Mar 18, 2019, Mar 12, 2019 and 1 more (4 updates tracked since 2019).

About Dr. Maria E Higgins O.d. NPPES

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

DR. MARIA E HIGGINS O.D. (NPI 1376514018) is an individual optometrist in West Chester, Pennsylvania, licensed in Pennsylvania (OEG-000300) and active in the NPI registry since January 2006. She is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1997).

NPPES Registry Identity

NPI1376514018
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameDR. MARIA E HIGGINSCredential: O.D.
Location Address422 COLLEGE AVEWest Chester, PA 19382-3556
Mailing Address422 College AveWest Chester, PA 19382-3556 · (412) 260-4103
Phone(412) 260-4103
Sole ProprietorYes
Medical School CMSPennsylvania College Of OptometryGraduated 1997
Enumeration DateJanuary 31, 2006
Last NPPES UpdateJune 11, 20214 updates tracked since enumeration
NPPES CertifiedJune 11, 2021
✔ NPI 1376514018 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Licenses✔ Licensed in PA · OEG-000300✔ Licensed in DC · OP1000396✔ Licensed in MD · TA2179
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
422 COLLEGE AVE, West Chester, PA 19382
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Other Names 1

Former Name (1)Dr. Maria H Eger O.d.

Other Identifiers 1

Other441182871PA · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.Insurance ›

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

Dr. Maria E Higgins O.d. 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 ID143318329
PECOS Enrollment IDI20071126000037, I20110523000166
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

6

Medicare enrollment records show Maria Higgins reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sightrite Medical MD LLC
62 mi
Optometrist
1300 WINDLASS DR
Baltimore, MD 21220
  • Reassigned Medicare billing, District of Columbia and Maryland enrollments
  • 10 clinicians in this Medicare group
NPI 1649755851 (212) 764-0008
Feltz Optometry Of PA LLC
70 mi
Optometrist
7 SAINT PAUL ST STE 820
Baltimore, MD 21202
  • Reassigned Medicare billing, Maryland and Pennsylvania enrollments
  • 4 clinicians in this Medicare group
NPI 1770099327 (248) 528-2116
Sight Services P.C.
93 mi
Optometrist
65 JAY ST
Newark, NJ 07103
  • Reassigned Medicare billing, Pennsylvania enrollment
  • Medicare enrollment name: Sight Services PC
  • 17 clinicians in this Medicare group
NPI 1255720124 (718) 633-2455
Sightrite Inc
101 mi
Optometrist
153 DIVISION AVE
Brooklyn, NY 11211
  • Reassigned Medicare billing, New York enrollment
  • 75 clinicians in this Medicare group
NPI 1336562644 (718) 633-2455
Sightrite Medical De LLC
102 mi
Optometrist
267 BROADWAY FL 2
Brooklyn, NY 11211
  • Reassigned Medicare billing, Delaware enrollment
  • 3 clinicians in this Medicare group
NPI 1699331793 (212) 764-0008
Swift Optometry Care PC
213 mi
Optometrist
26 SHENIPSIT LAKE RD
Tolland, CT 06084
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 8 clinicians in this Medicare group
NPI 1063753887 (212) 734-6621

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 5

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 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.
2,610 services1,765 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.
418 services409 patients
New patient problem focused exam of visual system 92002
A new patient problem-focused exam of the visual system is a basic evaluation of your eyes and vision. It includes checking your eye movements, visual acuity, and general eye health. It helps detect any potential issues early for timely treatment.
302 services302 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.
247 services247 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.
12 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19382 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
$137.17 typical visit price
range $59.88 – $180.99
Typical copayment $34.29 (range $14.97 – $45.24)
Most-billed visit code 99204
Established Patient
$74.47 typical visit price
range $19.30 – $147.29
Typical copayment $18.61 (range $4.82 – $36.82)
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.

88.33/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality56.66
Improvement Activities40

Reported Quality Measures

Age-Related Macular Degeneration (AMD): Dilated Macular Examination
100%45 patients5/55-star benchmark: 100%
Closing the Referral Loop: Receipt of Specialist Report
100%90 patients5/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
100%4,245 patients5/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 100% · 2,625 patients
100%2,625 patients
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 2

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

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier83 claims83 services$51.85 avg. paid by Medicare
Sphere, single vision, plano to plus or minus 4.00, per lens V2100
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier89 claims167 services$39.87 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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SILVER SIGHT LLC
Optometrist
422 COLLEGE AVE
WEST CHESTER, PA 19382
Chester County (412) 260-4103

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 Maria Higgins's NPI number?

The NPI number for Maria Higgins is 1376514018. It was assigned to this individual provider in the NPPES registry on January 31, 2006. The provider is also known as Dr. Maria H Eger O.D..

Where is Maria Higgins located?

Maria Higgins practices at 422 College Ave, West Chester, PA 19382. The listed phone number is (412) 260-4103.

What is Maria Higgins's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Maria Higgins enrolled in Medicare?

Yes. Maria 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.

Which organizations bill Medicare for Maria Higgins's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Maria Higgins reassigns Medicare benefits to 6 organizations: Sightrite Medical MD LLC (Baltimore, MD), Feltz Optometry Of PA LLC (Baltimore, MD), Sight Services P.C. (Newark, NJ), Sightrite Inc (Brooklyn, NY), Sightrite Medical De LLC (Brooklyn, NY) and 1 more organization, 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 Maria Higgins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Maria Higgins accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan list Maria 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.

When was this NPI record last updated?

The NPPES record for Maria Higgins was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.