Active NPI 1740242981 Individual Practitioner Male Practitioner

Dr. Michael W Higgins , OD

Optometrist • Butler, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Michael Higgins, OD is a certified Optometrist practicing in Butler, PA. With approximately 34 years of clinical experience since graduating from Pennsylvania College Of Optometry in 1992, Dr. Higgins delivers high-quality medical care to the local community at STIRLING EYECARE CENTER.

Dr. Higgins is affiliated with Stirling Eyecare Center and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient outpatient office visit, exam of visual field with extended testing, imaging of optic nerve. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

Stirling Eyecare Center
166 Point Plaza

Butler, PA 16001

Telephone 7242852618

Fax 7242857507

Associated Practice Facility / Clinic

🏢 Stirling Village Eye Care Facility NPI 1003862095

Medicare Profile & Education

Medical School

Pennsylvania College Of Optometry

Graduation Year

1992

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Butler, PA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

34 Yrs +9.0 yrs vs City Avg

City Avg: 25.0 Yrs

State Avg: 24.8 Yrs

Regional Practice Density

29 Specialists

Practicing in Butler, PA (2764 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

48.6% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Higgins (34 Years) 34 Yrs

Butler Specialty Average (25.0 Years) 25.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	92	71	$165.00	$86.06
92083 Exam of visual field with extended testing	36	25	$113.00	$58.19
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	33	24	$233.00	$121.32
92133 Imaging of optic nerve	26	21	$70.00	$31.54
92134 Imaging of retina	23	19	$74.00	$36.49
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	12	12	$25.00	$15.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	56	44	$165.00	$85.06
92014 Established patient complete exam of visual system	41	40	$229.00	$120.21
92134 Imaging of retina	25	25	$74.00	$36.24
92083 Exam of visual field with extended testing	23	21	$113.00	$56.35
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	22	19	$233.00	$122.40
92133 Imaging of optic nerve	18	17	$70.00	$30.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	68	52	$158.10	$87.03
92014 Established patient complete exam of visual system	44	43	$224.91	$122.13
92083 Exam of visual field with extended testing	37	26	$111.54	$60.19
92133 Imaging of optic nerve	27	21	$70.00	$32.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	18	15	$227.78	$124.59
92134 Imaging of retina	15	14	$73.20	$38.61
92020 Examination of cornea and iris using lens device and slit lamp	13	13	$50.92	$27.18

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	50	49	$139.00	$123.51
99213 Established patient office or other outpatient visit, typically 15 minutes	43	31	$98.00	$89.42
83861 Microfluid analysis of tears	41	17	$25.00	$22.48
92083 Exam of visual field with extended testing	30	25	$95.00	$61.32
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	24	$139.00	$127.03
92133 Imaging of optic nerve	20	17	$70.00	$33.26
92250 Photography of the retina	11	11	$105.00	$35.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	36	36	$139.00	$123.28
83861 Microfluid analysis of tears	32	14	$25.00	$22.37
92083 Exam of visual field with extended testing	27	22	$95.00	$61.31
99213 Established patient office or other outpatient visit, typically 15 minutes	26	22	$93.00	$73.57
92133 Imaging of optic nerve	22	17	$95.00	$33.69
92012 Established patient problem focused exam of visual system	19	16	$100.00	$86.23
92020 Examination of cornea and iris using lens device and slit lamp	17	17	$50.00	$27.23
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	14	$119.00	$106.88
92134 Imaging of retina	15	14	$70.00	$38.96

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
83861 Microfluid analysis of tears	54	19	$25.00	$22.03
92014 Established patient complete exam of visual system	37	36	$139.00	$123.28
92083 Exam of visual field with extended testing	33	27	$95.00	$61.94
99213 Established patient office or other outpatient visit, typically 15 minutes	30	25	$93.00	$72.59
92012 Established patient problem focused exam of visual system	23	19	$100.00	$85.80
92133 Imaging of optic nerve	18	17	$95.00	$33.68
92134 Imaging of retina	17	17	$70.00	$39.69
92250 Photography of the retina	16	16	$116.25	$45.02
92020 Examination of cornea and iris using lens device and slit lamp	12	12	$50.00	$27.04

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
83861 Microfluid analysis of tears	58	16	$25.00	$22.03
92014 Established patient complete exam of visual system	38	36	$139.00	$122.20
92083 Exam of visual field with extended testing	22	17	$95.00	$61.75
99213 Established patient office or other outpatient visit, typically 15 minutes	21	18	$93.00	$70.83
92133 Imaging of optic nerve	18	14	$95.00	$33.82
92012 Established patient problem focused exam of visual system	18	16	$100.00	$84.79
92020 Examination of cornea and iris using lens device and slit lamp	12	12	$50.00	$26.11

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
83861 Microfluid analysis of tears	90	28	$25.00	$22.21
92014 Established patient complete exam of visual system	48	47	$139.00	$118.75
99213 Established patient office or other outpatient visit, typically 15 minutes	40	33	$93.00	$70.44
92012 Established patient problem focused exam of visual system	35	25	$100.00	$82.01
92083 Exam of visual field with extended testing	32	26	$95.00	$61.35
92133 Imaging of optic nerve	28	24	$95.00	$33.22
92250 Photography of the retina	25	24	$118.40	$60.00
92020 Examination of cornea and iris using lens device and slit lamp	20	20	$57.00	$26.08
92134 Imaging of retina	15	13	$70.00	$39.15
92004 New patient complete exam of visual system	14	14	$166.00	$143.32

Medical Specialties & State Licenses

CMS Verified: 2024-04-29

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License PA OEG001084

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Upin

U34030 (PA)

Commercial Insurance / Payer ID Aetna Provider Id#

490600 (PA)

Commercial Insurance / Payer ID Highmark Id #

HI79266 (PA)

Commercial Insurance / Payer ID Rr Medicare

410040112 (PA)

Commercial Insurance / Payer ID State License

OEG001084 (PA)

Commercial Insurance / Payer ID Upmc

307056 (PA)

Hospital & Practice Group Affiliations

Stirling Eyecare Center

166 Point Plz, Butler, PA 160012572

Phone: 7242852618

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners

Dr. Emily Dean , OD

Optometrist

NPI 1649629593

Doctor of Optometry

Dr. Claudia Gonzalez , OD

Optometrist

NPI 1770534109

Doctor of Optometry

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active March 31, 2014

NPI status registered as active in NPPES database

📍

Updated Practice Location March 31, 2014

Registered at STIRLING EYECARE CENTER, 166 POINT PLAZA, BUTLER, PA 16001 (Tel: 7242852618)

📍

Updated Business Mailing Address March 31, 2014

Registered at STIRLING EYECARE CENTER, 166 POINT PLAZA, BUTLER, PA 16001 (Tel: 7242852618)

👤

Provider Name / Credentials Updated March 31, 2014

Recorded as MICHAEL HIGGINS, O.D.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 31, 2014

Optometrist (License #OEG001084 in PA)

🟢

Initial NPI Registration & Enumeration April 04, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1740242981

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 04, 2006

Last Update: April 29, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

Stirling Eyecare Center, 166 Point Plaza

Butler, PA 16001

Phone: 7242852618

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.