THOMAS S HIGGINS JR. MD
NPI 1750543237
Otolaryngology in Louisville, KY

Q: What is Thomas Higgins's NPI number?

The NPI number for Thomas Higgins is 1750543237. It was assigned to this individual provider in the NPPES registry on June 26, 2008.

Q: What is Thomas Higgins's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Higgins was last updated on February 3, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 26, 2008PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

6420 DUTCHMANS PKWY STE 380, LOUISVILLE, KY 40205(502) 894-8441(502) 894-4453 Get Directions Write a Review

NPPES record last updated: February 3, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 3, 2022, Jan 12, 2017 (2 updates tracked since 2017).

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About Thomas S Higgins Jr. Md NPPES

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

THOMAS S HIGGINS JR. MD (NPI 1750543237) is an individual otolaryngology provider in Louisville, Kentucky, licensed in Kentucky (TP529) and active in the NPI registry since June 2008. He is enrolled in Medicare PECOS, is affiliated with Norton Hospitals, Inc, and is a graduate of University Of Louisville School Of Medicine (2006).

NPPES Registry Identity

NPI1750543237

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameTHOMAS S HIGGINS JR.Credential: MD

Location Address6420 DUTCHMANS PKWY STE 380Louisville, KY 40205-3355

Mailing Address6420 Dutchmans Pkwy Ste 380Louisville, KY 40205-3355 · (502) 894-8441 · Fax (502) 894-4453

Phone(502) 894-8441

Fax(502) 894-4453

Sole ProprietorYes

Medical School CMSUniversity Of Louisville School Of MedicineGraduated 2006

Enumeration DateJune 26, 2008

Last NPPES UpdateFebruary 3, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 3, 2022

✔ NPI 1750543237 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in KY · TP529

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

6420 DUTCHMANS PKWY STE 380, Louisville, KY 40205

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, 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

Thomas S Higgins Jr. 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 ID4486824935

PECOS Enrollment IDI20120611000655, I20120710000391

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 20

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.

Professional service for preparation and provision of 1 or more antigens 95165

This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.

1,530 services34 patients

Test for allergy using allergenic extract injected into skin 95024

An allergy skin test involves injecting a small amount of allergenic extract into your skin. This test helps determine if you're allergic to specific substances. If allergic, a small red bump appears at the test site. It's safe and quick.

757 services19 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

586 services278 patients

Test for allergy using allergenic extract 95004

An allergy test with allergenic extract is a diagnostic method to identify substances causing allergic reactions. Small amounts of common allergens are introduced to your body, usually through skin pricks or blood tests. Your body's response helps determine your allergies.

482 services13 patients

Professional service for single injection of allergen 95115

A single allergen injection is a procedure where a small amount of a specific allergen is injected into your body. This is done to test your body's reaction to the allergen or to help your immune system become less sensitive to it, reducing allergic symptoms.

439 services15 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.

390 services210 patients

Professional service for multiple injections of allergen 95117

The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.

380 services21 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.

289 services174 patients

Biopsy or removal of nasal polyp or tissue using an endoscope 31237

A nasal biopsy or polyp removal is a procedure where an endoscope, a thin tube with a light and camera, is inserted into the nose. This allows the doctor to see and remove abnormal tissues or polyps, which are small growths. This procedure helps diagnose or treat nasal issues.

108 services59 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.

62 services62 patients

Ct guidance for needle or tube localization 77011

CT guidance for needle or tube localization is a procedure where a CT scan is used to accurately position a needle or tube within the body. It helps in diagnosing or treating conditions by ensuring precise placement for procedures such as biopsies or drainages.

61 services60 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

50 services43 patients

Comprehensive hearing and speech recognition test 92557

A comprehensive hearing and speech recognition test assesses your ability to hear and understand spoken words. It includes hearing tests to check for issues with sound perception and speech tests to evaluate your word recognition. It's a crucial step in identifying any hearing or speech problems.

25 services23 patients

Test to assess middle ear function 92567

A test to assess middle ear function, also known as an impedance audiometry, helps evaluate how well your middle ear works. It measures the movement of your eardrum in response to changes in air pressure. This can help identify issues like fluid build-up, ear infections, or eardrum perforations.

21 services19 patients

Computer-assisted procedure outside membrane covering brain 61782

A computer-assisted procedure outside the brain's membrane involves using advanced technology to help doctors accurately navigate and perform operations near the brain. This method enhances precision, safety, and effectiveness, potentially reducing recovery time.

20 services20 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

15 services12 patients

Removal of impacted cerumen (one or both ears) by physician on same date of service as audiologic function testing G0268

This procedure involves a doctor removing impacted earwax (cerumen) from one or both ears. This is often done on the same day as hearing function tests. The process helps to clear the ear canal, improving hearing and ensuring accurate test results.

15 services15 patients

Dilation of sphenoid and frontal nasal sinus using an endoscope 31298

This procedure involves enlarging the openings of your sphenoid and frontal nasal sinuses using a thin, lighted tube called an endoscope. It helps to alleviate symptoms of sinusitis, improving your breathing and reducing discomfort.

13 services13 patients

Removal of nasal sinus tissue using an endoscope 31267

This procedure, known as endoscopic sinus surgery, involves using a thin, flexible tube with a light and camera to view and remove problematic nasal sinus tissue. It helps to alleviate sinus issues and improve breathing.

11 services11 patients

Dilation of nasal sinus using an endoscope 31295

Dilation of the nasal sinus using an endoscope is a procedure to improve sinus drainage. A small tube with a camera, called an endoscope, is inserted into the nose. A balloon is then inflated to widen the sinus openings. This helps to relieve sinus pressure and symptoms.

11 services11 patients

Hospital Affiliations CMS Care Compare

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

Norton Hospitals, Inc

Acute Care Hospitals · Louisville, KY

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180088

Location200 East Chestnut StreetLouisville, KY 40202 · Jefferson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40205 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

$122.77 typical visit price

range $52.76 – $162.27

Typical copayment $30.69 (range $13.19 – $40.56)

Most-billed visit code 99204

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

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.

100/100

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

Individually scored

Quality

100

Improvement Activities

Reported Quality Measures

Breast Cancer Screening

91%338 patients4/55-star benchmark: 93%

Cervical Cancer Screening

77%356 patients4/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

89%791 patients5/55-star benchmark: 87%

Colorectal Cancer Screening

89%709 patients5/55-star benchmark: 88%

Documentation of Current Medications in the Medical Record

99%4,182 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

0%458 patients1/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

19%1,165 patients1/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%2,380 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 88% · 861 patients

Patients screened: 88% · 861 patients

100%46 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.

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Other Providers at the Same Location NPPES 5

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

CHRISTOPHER JOHN HARRYMAN MD

Otolaryngology