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DR. BRIAN EDWARD HIGGINS DO
NPI 1982601225
Physical Medicine & Rehabilitation in Lancaster, OH

Active since July 01, 2005PECOS EnrolledAccepts Medicare Assignment
71.23/100
CMS Quality Rating
2036 SCHORRWAY DR NW, LANCASTER, OH 43130(740) 681-1582(740) 681-1586 Get Directions Write a Review

NPPES record last updated: February 3, 2012. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Brian Edward Higgins Do NPPES

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

DR. BRIAN EDWARD HIGGINS DO (NPI 1982601225) is an individual physical medicine & rehabilitation provider in Lancaster, Ohio, licensed in Ohio (34004102) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Ohio University, College Of Osteopathic Medicine (1985).

NPPES Registry Identity

NPI1982601225
Entity TypeIndividualMale
Primary Taxonomy208100000X
Provider Legal NameDR. BRIAN EDWARD HIGGINSCredential: DO
Location Address2036 SCHORRWAY DR NWLancaster, OH 43130-8410
Mailing Address2036 Schorrway Dr NwLancaster, OH 43130-8410 · (740) 681-1582 · Fax (740) 681-1586
Phone(740) 681-1582
Fax(740) 681-1586
Sole ProprietorYes
Medical School CMSOhio University, College Of Osteopathic MedicineGraduated 1985
Enumeration DateJuly 1, 2005
Last NPPES UpdateFebruary 3, 2012
✔ NPI 1982601225 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Medicine & RehabilitationAllopathic & Osteopathic Physicians
Taxonomy Code208100000X
License✔ Licensed in OH · 34004102
Definition
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.
2036 SCHORRWAY DR NW, Lancaster, OH 43130
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Other Identifiers 3

Medicaid0637065OH
Medicare UPINA16538
Medicare ID-Type UnspecifiedHI4148301OH

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

Dr. Brian Edward Higgins Do 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 ID749268217
PECOS Enrollment IDI20041215000082
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 8

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.
202 services109 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.
56 services46 patients
Needle measurement of electrical activity in arm or leg muscles, complete study 95886
This procedure, known as an electromyography (EMG), involves inserting a small needle into your arm or leg muscles to measure their electrical activity. This complete study helps diagnose issues with nerves or muscles, providing valuable data for your treatment plan.
53 services41 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.
47 services47 patients
Nerve conduction, 5-6 studies 95909
Nerve conduction studies involve testing the speed and strength of signals traveling through your nerves. This helps identify any nerve damage or dysfunction. For 5-6 studies, this means multiple nerves will be tested. Small electrodes are placed on your skin to send and receive signals, causing minimal discomfort.
23 services23 patients
Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level 64483
This procedure involves injecting a mix of numbing and anti-inflammatory medication into a specific nerve root in the lower back. It helps manage pain and reduce inflammation. The process is guided by imaging technology for precision.
21 services20 patients

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.

71.23/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality52.72
Promoting Interoperability87
Improvement Activities40
Cost58.69

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
85%289 patients4/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,833 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
85%433 patients4/55-star benchmark: 100%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
4%52 patients1/55-star benchmark: 98%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
26%292 patients2/55-star benchmark: 100%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
Percentage of patients aged 12 years and older screened for depression on the date of the encounter using an age appropriate standardized depression screening tool AND if positive, a follow-up plan is documented on the date of the positive screen
75%673 patients4/55-star benchmark: 100%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
29%69 patients2/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
92%395 patients4/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
86%292 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%292 patients1/55-star benchmark: 79%
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.

Other Providers at the Same Location NPPES 7

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

DR. JED ALEXANDER BELL D.O.
Physical Medicine & Rehabilitation
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 681-1582
DR. FRANK JAMES MESZAROS M.D.
Physical Medicine & Rehabilitation
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 681-1582
DR. STEPHANIE J OTT M.D.
Internal Medicine (Rheumatology)
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 870-4030
JAMES ALLEN WRIGHT PA-C
Physician Assistant
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 870-4030
BRIAN BUCK
Physician Assistant (Medical)
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 681-1582
BUCKEYE SPINE & REHAB INC
Physical Medicine & Rehabilitation
2036 SCHORRWAY DR NW, BOX 847
LANCASTER, OH 43130
Fairfield County (740) 681-1582
GWELLA RHEUMATOLOGY LLC
Internal Medicine (Rheumatology)
2036 SCHORRWAY DR NW
LANCASTER, OH 43130
Fairfield County (740) 870-4030

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 Brian Higgins's NPI number?

The NPI number for Brian Higgins is 1982601225. It was assigned to this individual provider in the NPPES registry on July 1, 2005.

Where is Brian Higgins located?

Brian Higgins practices at 2036 Schorrway Dr NW, Lancaster, OH 43130. The listed phone number is (740) 681-1582.

What is Brian Higgins's specialty?

The primary specialty registered for this NPI is Physical Medicine & Rehabilitation with taxonomy code 208100000X.

Is Brian Higgins enrolled in Medicare?

Yes. Brian 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 Brian Higgins accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Brian 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.

When was this NPI record last updated?

The NPPES record for Brian Higgins was last updated on February 3, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.