PHILLIP A. HIGGINS MD
NPI 1306956594
Obstetrics & Gynecology in Rockford, IL
NPI Status: Active since August 30, 2006
Contact Information
3401 N PERRYVILLE RD
ROCKFORD, IL
ZIP 61114
Phone: (815) 971-2000
- Individual
- Male
- Obstetrics & Gynecology
- Accepts Insurance
- PECOS Enrolled
About PHILLIP HIGGINS
This page provides the complete NPI Profile along with additional information for Phillip Higgins, a women's health care provider established in Rockford, Illinois with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1306956594 assigned on August 2006. The practitioner's primary taxonomy code is 207V00000X with license number 036075329 (IL). The provider is registered as an individual and his NPI record was last updated 16 years ago.
- NPI
- 1306956594
- Provider Name
- PHILLIP A. HIGGINS MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 3401 N PERRYVILLE RD ROCKFORD, IL 61114
- Location Phone
- (815) 971-2000
- Mailing Address
- 3401 N PERRYVILLE RD ROCKFORD, IL 61114
- Mailing Phone
- (815) 971-2000
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-30-2006
- Last Update Date
- 01-21-2010
- Code Navigator
Women's health care providers like Phillip Higgins treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 036075329
- License State
- IL
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| E18776 | MEDICARE UPIN (02) | IL | |
| 036075329 | MEDICAID (05) | IL | |
| 610470 | MEDICARE PIN (08) | IL |
Medicare Participation & PECOS Enrollment Status
Phillip Higgins is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 61114 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $127.46
- Minimum New Patient Price $54.8
- Maximum New Patient Price $168.44
- Average New Patient Copayment $31.86
- Minimum New Patient Copayment $13.7
- Maximum New Patient Copayment $42.11
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.64
- Minimum Established Patient Price $17.16
- Maximum Established Patient Price $136.56
- Average Established Patient Copayment $17.16
- Minimum Established Patient Copayment $4.29
- Maximum Established Patient Copayment $34.14
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 0 | 6 | 9 | 5 | 6 | 5 | 9 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 0 | 6 | 18 | 5 | 12 | 5 | 18 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 0 + 6 + 1 + 8 + 5 + 1 + 2 + 5 + 1 + 8 + 24 = 66 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 66 = 4 | 4 | ||||||||
The NPI number 1306956594 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1285606970 | LUCY MARTIN Individual | Nurse Practitioner | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1831209022 | WILLARD D. MOORE MD Individual | Internal Medicine | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1427168616 | SHELDON A. WEISS MD Individual | Internal Medicine (Geriatric Medicine) | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1780794974 | RICHARD B. FELLARS MD Individual | Family Medicine | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1871603050 | AARON G. COATES MD Individual | Internal Medicine | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1992815187 | IAN H. SCHERMER MD Individual | Family Medicine | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1578623195 | PAUL R. SCHROEDER MD Individual | Family Medicine | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1740439215 | DR. MAGDALENA NOWAK MD Individual | Family Medicine | 3401 N PERRYVILLE RD ROCKFORD HEALTH PHYSICIANS ROCKFORD, IL 61114 (815) 971-2000 |
| 1659667186 | PRADEEPA FRANKLIN PT Individual | Physical Therapist | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1205261724 | MICHELLE LEE CLEVELAND NP Individual | Nurse Practitioner (Adult Health) | 3401 N PERRYVILLE RD SUITE 303 ROCKFORD, IL 61114 (815) 971-1060 |
| 1225289358 | LISA A ANGEL PT Individual | Physical Therapist | 3401 N PERRYVILLE RD PHYSICAL THERAPY DEPT ROCKFORD, IL 61114 (815) 971-2000 |
| 1598164469 | HEIDI JOHNS-FIEDLER Individual | Speech-Language Pathologist | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1962511865 | MR. MICHAEL JAMES WOOD PT, MPT Individual | Physical Therapist | 3401 N PERRYVILLE RD PHYSICAL THERAPY DEPT ROCKFORD, IL 61114 (815) 971-2000 |
| 1821055484 | LYNETTE M CASTRONOVO N.P. Individual | Nurse Practitioner (Gerontology) | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1285669895 | TRACY C BRITO M.D. Individual | Phlebology | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1518229210 | DR. JUSTIN WILLIAM JOHNSON O.D. Individual | Optometrist | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2800 |
| 1528513124 | MRS. REBECCA J NYGREN P.T., D.P.T. Individual | Physical Therapist (Orthopedic) | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1295188803 | NICOLE M MOORE APN Individual | Nurse Practitioner (Family) | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1750300901 | MACHELLE M DOPKINS CCC Individual | Audiologist | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
| 1720068695 | FAZLUR R. ZAHURULLAH MD Individual | Otolaryngology (Plastic Surgery within the Head & Neck) | 3401 N PERRYVILLE RD ROCKFORD, IL 61114 (815) 971-2000 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1306956594, enumerated in the NPI registry as an "individual" on August 30, 2006
The provider is located at 3401 N Perryville Rd Rockford, Il 61114 and the phone number is (815) 971-2000
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X
The provider might be accepting Accepts: Molina Healthcare, Oscar Insurance Company of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $127.46 with an average copayment of $31.86 for new patient appointments. Established patients should expect a typical charge of $68.64 and an average copayment of 17.16. Please review your insurance plan or contact the provider directly to determine your specific costs.
This NPI record was last updated on August 30, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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