DR. JOHN PATRICK HIGINBOTHAM OD
NPI 1952465528
Optometrist in Frederick, MD

Active since December 20, 2006PECOS EnrolledAccepts Medicare Assignment
1202 E PATRICK ST STE 4, FREDERICK, MD 21701(301) 663-8858(301) 663-8871 Get Directions Write a Review

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

About Dr. John Patrick Higinbotham Od NPPES

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

DR. JOHN PATRICK HIGINBOTHAM OD (NPI 1952465528) is an individual optometrist in Frederick, Maryland, licensed in Maryland (TA1174) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS and is a graduate of Pennsylvania College Of Optometry (1992).

NPPES Registry Identity

NPI1952465528
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JOHN PATRICK HIGINBOTHAMCredential: OD
Location Address1202 E PATRICK ST STE 4Frederick, MD 21701-3167
Mailing Address1202 E Patrick St Ste 4Frederick, MD 21701-3167 · (301) 663-8858 · Fax (301) 663-8871
Fax(301) 663-8871
Sole ProprietorYes
Medical School CMSPennsylvania College Of OptometryGraduated 1992
Enumeration DateDecember 20, 2006
Last NPPES UpdateFebruary 20, 2026
NPPES CertifiedFebruary 20, 2026
NPI 1952465528 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License Licensed in MD · TA1174
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
1202 E PATRICK ST STE 4, Frederick, MD 21701

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

Dr. John Patrick Higinbotham Od 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 ID8729185079
PECOS Enrollment IDI20070521000407
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 3

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.
432 services432 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.
172 services146 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.
69 services69 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 21701 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
$133.05 typical visit price
range $57.99 – $175.57
Typical copayment $33.26 (range $14.49 – $43.89)
Most-billed visit code 99204
Established Patient
$72.23 typical visit price
range $18.66 – $143.02
Typical copayment $18.05 (range $4.66 – $35.75)
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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Frames, purchases V2020
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier19 claims19 services$49.58 avg. paid by Medicare
Sphere, bifocal, plano to plus or minus 4.00d, per lens V2200
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier11 claims18 services$52.64 avg. paid by Medicare
Sphere, trifocal, plano to plus or minus 4.00d, per lens V2300
Other-Vision, Hearing, and Speech Services · category OC000N
1 supplier20 claims35 services$59.02 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 3

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

Nurse Practitioner
1202 E PATRICK ST STE 4
FREDERICK, MD 21701
Durable Medical Equipment & Medical Supplies
1202 E PATRICK ST STE 4
FREDERICK, MD 21701
Nurse Practitioner (Family)
1202 E PATRICK ST STE 4
FREDERICK, MD 21701

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 John Higinbotham's NPI number?

The NPI number for John Higinbotham is 1952465528. It was assigned to this individual provider in the NPPES registry on December 20, 2006.

Where is John Higinbotham located?

John Higinbotham practices at 1202 E Patrick St Ste 4, Frederick, MD 21701. The listed phone number is (301) 663-8858.

What is John Higinbotham's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is John Higinbotham enrolled in Medicare?

Yes. John Higinbotham 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 John Higinbotham accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list John Higinbotham 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.

When was this NPI record last updated?

The NPPES record for John Higinbotham was last updated on February 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.