KRISTAN L HIGGINBOTHAM
NPI 1467715094
Nurse Practitioner - Family in Marion, IN

Active since June 19, 2012PECOS EnrolledAccepts Medicare Assignment
83.71/100
CMS Quality Rating
1391 N BALDWIN AVE, MARION, IN 46952(765) 660-7900(765) 671-7751 Get Directions Write a Review

NPPES record last updated: October 20, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kristan L Higginbotham NPPES

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

KRISTAN L HIGGINBOTHAM (NPI 1467715094) is an individual family provider in Marion, Indiana, licensed in Indiana (28159335A) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Marion General Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1467715094
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameKRISTAN L HIGGINBOTHAM
Location Address1391 N BALDWIN AVEMarion, IN 46952-1913
Mailing Address330 N Wabash Ave Ste G-20Marion, IN 46952-2605 · (765) 660-7616 · Fax (765) 651-7313
Fax(765) 671-7751
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJune 19, 2012
Last NPPES UpdateOctober 20, 2020
NPPES CertifiedOctober 20, 2020
NPI 1467715094 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License Licensed in IN · 28159335A
1391 N BALDWIN AVE, Marion, IN 46952

Other Identifiers 2

Medicaid201079220IN
Other000000779644Anthem

Accepted Insurance

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

Kristan L Higginbotham 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 ID2769638022
PECOS Enrollment IDI20120802000283
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.
253 services192 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.
30 services30 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.
28 services28 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.
26 services24 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.
21 services21 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.
20 services20 patients

Hospital Affiliations CMS Care Compare

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

Marion General Hospital

Acute Care Hospitals · Marion, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150011
Location441 N Wabash AveMarion, IN 46952 · Grant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46952 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

83.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.94
Promoting Interoperability95
Improvement Activities40

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.

Bedside drainage bag, day or night, with or without anti-reflux device, with or without tube, each A4357
DME-Orthotic Devices · category DF000N
1 supplier12 claims24 services$7.80 avg. paid by Medicare
Ostomy skin barrier, with flange (solid, flexible or accordion), extended wear, without built-in convexity, 4 x 4 inches or smaller, each A4409
DME-Orthotic Devices · category DF010N
1 supplier12 claims120 services$5.35 avg. paid by Medicare
Ostomy pouch, urinary; for use on barrier with non-locking flange, with faucet-type tap with valve (2 piece), each A4432
DME-Orthotic Devices · category DF010N
1 supplier12 claims240 services$3.18 avg. paid by Medicare
Nebulizer, with compressor E0570
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.95 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
1 supplier22 claims23 services$114.08 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 9

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

Family Medicine
1391 N BALDWIN AVE
MARION, IN 46952
Social Worker (Clinical)
1391 N BALDWIN AVE
MARION, IN 46952
General Practice
1391 N BALDWIN AVE
MARION, IN 46952
Physical Medicine & Rehabilitation
1391 N BALDWIN AVE, HIGHWAY 9
MARION, IN 46952
Family Medicine
1391 N BALDWIN AVE
MARION, IN 46952
Family Medicine
1391 N BALDWIN AVE
MARION, IN 46952
Nurse Practitioner (Family)
1391 N BALDWIN AVE
MARION, IN 46952
Otolaryngology
1391 N BALDWIN AVE
MARION, IN 46952

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 Kristan Higginbotham's NPI number?

The NPI number for Kristan Higginbotham is 1467715094. It was assigned to this individual provider in the NPPES registry on June 19, 2012.

Where is Kristan Higginbotham located?

Kristan Higginbotham practices at 1391 N Baldwin Ave, Marion, IN 46952. The listed phone number is (765) 660-7900.

What is Kristan Higginbotham's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Kristan Higginbotham enrolled in Medicare?

Yes. Kristan Higginbotham 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.

What insurance does Kristan Higginbotham accept?

Health plans from CareSource list Kristan Higginbotham 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 Kristan Higginbotham affiliated with any hospitals?

According to CMS data, Kristan Higginbotham is affiliated with Marion General Hospital.

When was this NPI record last updated?

The NPPES record for Kristan Higginbotham was last updated on October 20, 2020. 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.