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MR. GREGORY MALCOLM HIGGINS
NPI 1912529397
Nurse Practitioner in Wellington, OH

Active since May 08, 2020PECOS EnrolledAccepts Medicare Assignment
79.48/100
CMS Quality Rating
19934 STATE ROUTE 58, WELLINGTON, OH 44090(440) 310-6637 Get Directions Write a Review

NPPES record last updated: May 8, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mr. Gregory Malcolm Higgins NPPES

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

MR. GREGORY MALCOLM HIGGINS (NPI 1912529397) is an individual nurse practitioner in Wellington, Ohio, licensed in Ohio (APRN.CNP.026699) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, is affiliated with Uh Cleveland Medical Center, and is a graduate of Other (2020).

NPPES Registry Identity

NPI1912529397
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameMR. GREGORY MALCOLM HIGGINS
Location Address19934 STATE ROUTE 58Wellington, OH 44090-9468
Mailing Address19934 State Route 58Wellington, OH 44090-9468 · (440) 310-6637
Phone(440) 310-6637
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateMay 8, 2020
NPPES CertifiedMay 8, 2020
✔ NPI 1912529397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in OH · APRN.CNP.026699
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
19934 STATE ROUTE 58, Wellington, OH 44090
Open in Google Maps ↗

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, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gregory Malcolm Higgins 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 ID648698829
PECOS Enrollment IDI20200921001747
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

2

Medicare enrollment records show Gregory Higgins reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Hospitals Medical Group Inc
39 mi
Multi-Specialty
11100 EUCLID AVE
Cleveland, OH 44106
  • Reassigned Medicare billing, Ohio enrollment
  • 3,958 clinicians in this Medicare group
NPI 1669499414 (216) 844-1000
Inpatient Medical Services, Inc.
40 mi
Internal Medicine
5700 DARROW RD STE 106
Hudson, OH 44236
  • Reassigned Medicare billing, Ohio enrollment
  • 215 clinicians in this Medicare group
NPI 1093756314 (844) 474-4019

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 2

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.

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
123 services120 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
38 services37 patients

Hospital Affiliations CMS Care Compare 3

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

Uh Cleveland Medical Center

Acute Care Hospitals · Cleveland, OH
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360137
Location11100 Euclid AvenueCleveland, OH 44106 · Cuyahoga County
Emergency services Birthing friendly

University Hospitals - Elyria Medical Center

Acute Care Hospitals · Elyria, OH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360145
Location630 East River StreetElyria, OH 44035 · Lorain County

Cleveland Clinic

Acute Care Hospitals · Cleveland, OH
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number360180
Location9500 Euclid AvenueCleveland, OH 44195 · Cuyahoga County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44090 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

79.48/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.51
Promoting Interoperability100
Improvement Activities40
Cost63.09

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 Gregory Higgins's NPI number?

The NPI number for Gregory Higgins is 1912529397. It was assigned to this individual provider in the NPPES registry on May 8, 2020.

Where is Gregory Higgins located?

Gregory Higgins practices at 19934 State Route 58, Wellington, OH 44090. The listed phone number is (440) 310-6637.

What is Gregory Higgins's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Gregory Higgins enrolled in Medicare?

Yes. Gregory 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 Gregory Higgins's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gregory Higgins reassigns Medicare benefits to 2 organizations: University Hospitals Medical Group Inc (Cleveland, OH) and Inpatient Medical Services, Inc. (Hudson, OH). 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 Gregory Higgins's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gregory Higgins accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and MedMutual list Gregory 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 Gregory Higgins affiliated with any hospitals?

According to CMS data, Gregory Higgins is affiliated with Uh Cleveland Medical Center, University Hospitals - Elyria Medical Center and Cleveland Clinic.

When was this NPI record last updated?

The NPPES record for Gregory Higgins was last updated on May 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.