MICHAEL E HIGGINS M.D.
NPI 1760460570
Orthopaedic Surgery in Hampton, VA

Q: What is Michael Higgins's NPI number?

The NPI number for Michael Higgins is 1760460570. It was assigned to this individual provider in the NPPES registry on January 3, 2006.

Q: What is Michael 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 Michael Higgins was last updated on February 5, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since January 03, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

901 ENTERPRISE PKWY STE 900, HAMPTON, VA 23666(757) 827-2480(757) 827-2566 Get Directions Write a Review

NPPES record last updated: February 5, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Michael E Higgins M.d. NPPES

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

MICHAEL E HIGGINS M.D. (NPI 1760460570) is an individual orthopaedic surgery provider in Hampton, Virginia, licensed in Virginia (0101237682) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Bon Secours Maryview Medical Center, and is a graduate of Other (2000).

NPPES Registry Identity

NPI1760460570

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameMICHAEL E HIGGINSCredential: M.D.

Location Address901 ENTERPRISE PKWY STE 900Hampton, VA 23666-6250

Mailing Address901 Enterprise Parkway, Suite 900Hampton, VA 23666 · (757) 827-2480 · Fax (757) 827-2566

Phone(757) 827-2480

Fax(757) 827-2566

Sole ProprietorNo

Medical School CMSOtherGraduated 2000

Enumeration DateJanuary 3, 2006

Last NPPES UpdateFebruary 5, 2024

NPPES CertifiedFebruary 5, 2024

✔ NPI 1760460570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in VA · 0101237682

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.

Also ListedOrthopaedic Surgery · Adult Reconstructive Orthopaedic SurgeryTaxonomy 207XS0114X · License 0101237682 (VA)

901 ENTERPRISE PKWY STE 900, Hampton, VA 23666

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Other Identifiers 4

Medicaid010285411VA

Other239627VA · Anthem

Other10012033VA · Optima/sentara

Other2167454VA · Mamsi

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

Michael E 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 ID840220919

PECOS Enrollment IDI20050818000069

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 15

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.

681 services541 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.

529 services426 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.

368 services338 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.

313 services298 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.

190 services158 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.

160 services142 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.

154 services154 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.

104 services102 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.

96 services96 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

87 services49 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.

74 services70 patients

Mri scan of leg joint without contrast 73721

An MRI scan of your leg joint is a non-invasive procedure that uses magnetic fields and radio waves to create detailed images of the structures within your leg. This helps doctors diagnose or monitor conditions without using contrast dye.

69 services65 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.

64 services64 patients

Injection of trigger points, 3 or more muscles 20553

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

49 services47 patients

Removal of both knee cartilages using an endoscope 29880

This procedure, also known as bilateral knee arthroscopy, involves using a small camera (endoscope) to view and remove damaged cartilage from both knees. It's a minimally invasive surgery aimed at relieving pain and improving mobility.

34 services32 patients

Hospital Affiliations CMS Care Compare 5

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

Bon Secours Maryview Medical Center

Acute Care Hospitals · Portsmouth, VA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490017

Location3636 High StreetPortsmouth, VA 23707 · Portsmouth City County

Emergency services

Sentara Obici Hospital

Acute Care Hospitals · Suffolk, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number490044

Location2800 Godwin BoulevardSuffolk, VA 23439 · Suffolk City County

Emergency services Birthing friendly

Sentara Williamsburg Regional Medical Center

Acute Care Hospitals · Williamsburg, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490066

Location100 Sentara CircleWilliamsburg, VA 23188 · James City County

Emergency services Birthing friendly

Sentara Careplex Hospital

Acute Care Hospitals · Hampton, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490093

Location3000 Coliseum DriveHampton, VA 23666 · Hampton City County

Emergency services Birthing friendly

Riverside Walter Reed Hospital

Acute Care Hospitals · Gloucester, VA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490130

Location7519 Hospital RoadGloucester, VA 23061 · Gloucester County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 23666 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$70.08 typical visit price

range $18.07 – $138.91

Typical copayment $17.52 (range $4.51 – $34.72)

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.

75/100

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

Scored as part of a group practice

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.

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

6 suppliers56 claims56 services$37.32 avg. paid by Medicare

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

2 suppliers15 claims15 services$13.41 avg. paid by Medicare

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

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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.

DAVINA ANN GILLESPIE FNP

Nurse Practitioner (Family)