Individual provider Active NPI

William Higginbotham III, MD

  • Orthopaedic Surgery Physician
  • Southfield, MI
National Provider Identifier
1285605139
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
4301042913 Issued in MI
Practice address
22250 Providence Dr
Suite 401
Southfield, MI 48075-4825
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Jan 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 4301042913 MI Primary

Addresses

Primary practice location

22250 Providence Dr
Suite 401
Southfield, MI 48075-4825

Mailing address

18444 N 25TH Ave
Ste 310
Phoenix, AZ 85023-1261
Phone (866) 974-2673

Other identifiers 1

IdentifierTypeStateIssuer
4341367MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100415000504 MI Practitioner - Orthopedic Surgery 3072601244 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
86.44 of 100Reported as individual
Quality
64.76
Promoting interoperability
100
Improvement activities
40
Cost
90.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The Porretta Center for Orthopaedic Surgery, PLLC CurrentSince Nov 1, 1999 Accepting new patients
The Porretta Center for Orthopaedic Surgery, PLLC Orthopaedic Surgery CurrentSince Nov 1, 1999 Accepting new patients
Medical X-Ray Consultants, LTD Past Accepting new patients

Locations

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

26750 Providence Pkwy
Ste 200
Novi, MI 48374
Phone (248) 349-7015

22250 Providence Dr
Ste 40
Southfield, MI 48075
Phone (248) 563-0306

22250 Providence Dr
Ste 401
Southfield, MI 48075
Phone (248) 349-7015

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1285605139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE",
            "address_2": "STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231261",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22250 PROVIDENCE DR",
            "address_2": "SUITE 401",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480754825",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "WILLIAM",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-30",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "4301042913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4341367",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.