DR. MATTHEW DOUGLAS HIGGINS M.D.
NPI 1629205752
Orthopaedic Surgery in Chattanooga, TN

Q: What is Matthew Higgins's NPI number?

The NPI number for Matthew Higgins is 1629205752. It was assigned to this individual provider in the NPPES registry on June 16, 2009.

Q: What is Matthew Higgins's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Matthew Higgins was last updated on September 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 June 16, 2009PECOS EnrolledAccepts Medicare Assignment

96.19/100

CMS Quality Rating

979 E 3RD ST, SUITE C-430, CHATTANOOGA, TN 37403(423) 778-4900(423) 778-4901 Get Directions Write a Review

NPPES record last updated: September 21, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Dr. Matthew Douglas Higgins M.d. NPPES

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

DR. MATTHEW DOUGLAS HIGGINS M.D. (NPI 1629205752) is an individual orthopaedic surgery provider in Chattanooga, Tennessee, licensed in Tennessee (47906) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Hamilton Medical Center, and is a graduate of Loma Linda University School Of Medicine (2009).

NPPES Registry Identity

NPI1629205752

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. MATTHEW DOUGLAS HIGGINSCredential: M.D.

Location Address979 E 3RD ST, SUITE C-430Chattanooga, TN 37403-2136

Mailing Address975 E 3rd St, Attn: Provider EnrollmentChattanooga, TN 37403-2147 · (423) 778-5630 · Fax (423) 778-3146

Phone(423) 778-4900

Fax(423) 778-4901

Sole ProprietorNo

Medical School CMSLoma Linda University School Of MedicineGraduated 2009

Enumeration DateJune 16, 2009

Last NPPES UpdateSeptember 21, 2015

✔ NPI 1629205752 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in TN · 47906

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

979 E 3RD ST, Chattanooga, TN 37403

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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

Dr. Matthew Douglas Higgins M.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 ID9133365745

PECOS Enrollment IDI20150729010094

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 19

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 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.

291 services240 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

218 services174 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

192 services162 patients

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.

168 services157 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

96 services93 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

89 services89 patients

X-ray of hip, 1 view 73501

An X-ray of the hip, 1 view, is a quick, painless test where a small amount of radiation is used to produce images of the hip joint. This helps in diagnosing conditions like arthritis or fractures. You'll be positioned so that the X-ray machine can capture the best image of your hip.

84 services72 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.

77 services77 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

75 services70 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.

71 services71 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

43 services38 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

20 services20 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

19 services19 patients

Computer-assisted surgery for muscle and bone procedure 20985

Computer-assisted surgery for muscle and bone procedures involves using a computer to aid in planning and performing surgery. This technology helps increase precision, reduce invasiveness, and improve outcomes. It's commonly used in orthopedic surgeries like joint replacements.

16 services16 patients

X-ray of hip, 2-3 views 73502

13 services13 patients

X-ray of both hips, 2 views 73521

An X-ray of both hips, 2 views, is an imaging test that uses a small amount of radiation to create detailed pictures of your hip joints. This procedure helps to detect fractures, infections, or other abnormalities in the hip area. Two different angles will be captured for a comprehensive assessment.

13 services12 patients

X-ray of both hips, 3-4 views 73522

An X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.

13 services13 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

13 services13 patients

X-ray of both hips, minimum of 5 views 73523

An X-ray of both hips with a minimum of 5 views is a non-invasive imaging test. It uses a small amount of radiation to produce images of the hip joints from different angles. This aids in diagnosing conditions such as fractures, arthritis, or other hip abnormalities.

12 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Hamilton Medical Center

Acute Care Hospitals · Dalton, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110001

Location1200 Memorial DriveDalton, GA 30720 · Whitfield County

Birthing friendly

Adventhealth Murray

Acute Care Hospitals · Chatsworth, GA

OwnershipVoluntary non-profit - Private

CMS Certification Number110050

Location707 Old Dalton Ellijay Road, PO Box 1406Chatsworth, GA 30705 · Murray County

Emergency services

Memorial Healthcare System, Inc

Acute Care Hospitals · Chattanooga, TN

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number440091

Location2525 Desales AveChattanooga, TN 37404 · Hamilton County

Erlanger Medical Center

Acute Care Hospitals · Chattanooga, TN

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number440104

Location975 E 3rd StChattanooga, TN 37403 · Hamilton County

Emergency services Birthing friendly

Parkridge Medical Center

Acute Care Hospitals · Chattanooga, TN

4/5 CMS rating

OwnershipProprietary

CMS Certification Number440156

Location2333 Mccallie AveChattanooga, TN 37404 · Hamilton County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37403 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

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

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.

96.19/100

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

Scored through an Alternative Payment Model

Quality

85.2

Promoting Interoperability

100

Improvement Activities

Reported Quality Measures

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)

Lower rates are better for this measure.

0.02%

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.

Cane, includes canes of all materials, adjustable or fixed, with tip E0100

DME-Other DME · category DE000N

1 supplier11 claims11 services$20.33 avg. paid by Medicare

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

2 suppliers38 claims38 services$48.95 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.

DR. JEFFREY W. GEFTER M.D.

Radiology (Radiation Oncology)

979 E 3RD ST, SUITE G-20
CHATTANOOGA, TN 37403

Hamilton County (423) 756-0018

DR. LUIS FELIPE LEMUS MD

Student in an Organized Health Care Education/Training Program

979 E 3RD ST
CHATTANOOGA, TN 37403

Hamilton County (423) 778-8179

MRS. DANA WENSEL BUTLER

Nurse Practitioner (Family)

979 E 3RD ST, SUITE C 925
CHATTANOOGA, TN 37403

Hamilton County (423) 778-5910

DR. CHANNAPPA CHANDRA M.D.

Orthopaedic Surgery

979 E 3RD ST, SUITE C430
CHATTANOOGA, TN 37403

Hamilton County (423) 624-6584

DR. JASON PAUL REHM MD

Surgery (Plastic and Reconstructive Surgery)

979 E 3RD ST, SUITE C920
CHATTANOOGA, TN 37403

Hamilton County (423) 756-7134

DR. MICHAEL G CARR M.D.

Surgery (Pediatric Surgery)

979 E 3RD ST, STE 300
CHATTANOOGA, TN 37403

Hamilton County (423) 267-0466

DR. CAULEY W HAYES MD

Surgery (Surgery of the Hand)

979 E 3RD ST, SUITE C920
CHATTANOOGA, TN 37403

Hamilton County (423) 756-7134

DR. OLUKAYODE AKINLAJA M.D.

Obstetrics & Gynecology (Obstetrics)

979 E 3RD ST, SUITE C-725
CHATTANOOGA, TN 37403

Hamilton County (423) 778-2580

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 Matthew Higgins's NPI number?

The NPI number for Matthew Higgins is 1629205752. It was assigned to this individual provider in the NPPES registry on June 16, 2009.

Where is Matthew Higgins located?

Matthew Higgins practices at 979 E 3rd St Suite C-430, Chattanooga, TN 37403. The listed phone number is (423) 778-4900.

What is Matthew Higgins's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Matthew Higgins enrolled in Medicare?

Yes. Matthew 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.

What insurance does Matthew Higgins accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 3 other insurers list Matthew 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.

Is Matthew Higgins affiliated with any hospitals?

According to CMS data, Matthew Higgins is affiliated with Hamilton Medical Center, Adventhealth Murray, Memorial Healthcare System, Inc, Erlanger Medical Center and Parkridge Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Higgins was last updated on September 21, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.