Individual provider Active NPI

Devan Higginbotham, MD

  • Orthopaedic Surgery of the Spine Physician
  • Fresno, CA
National Provider Identifier
1306409677
Registry record updated Sep 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
196222 Issued in CA
Practice address
1630 E Herndon Ave
Fresno, CA 93720-3391
Phone
(916) 734-3526
NPI assigned
Apr 22, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 196222 CA Primary

Addresses

Primary practice location

1630 E Herndon Ave
Fresno, CA 93720-3391

Mailing address

1270 E Spruce Ave
Fresno, CA 93720-3312
Phone (916) 734-3526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240807004511 CA Practitioner - Orthopedic Surgery 4082949540 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Foundation Medical GroupGroup PAC ID 0345406294, 282 clinicians
Sierra Pacific Orthopaedic Center Medical Group, Inc.Group PAC ID 8426941105, 28 clinicians

Practice addresses (Care Compare)

1630 E Herndon Ave
Fresno, CA 93720-3391
Phone (559) 290-7051

Hospital & facility affiliations

  • Saint Agnes Medical Center Hospital, Fresno, CA, CCN 050093
  • Clovis Community Medical Center Hospital, Clovis, CA, CCN 050492
  • Fresno Surgical Hospital Hospital, Fresno, CA, CCN 050708
  • Kaweah Health Medical Center Hospital, Visalia, CA, CCN 050057
  • Mercy Medical Center Hospital, Merced, CA, CCN 050444
  • San Joaquin Valley Rehabilitation Hosp Inpatient rehabilitation facility, Fresno, CA, CCN 053032

Merit-based Incentive Payment System (MIPS)

Final score
83.15 of 100Reported as group
Quality
64.8
Promoting interoperability
100
Improvement activities
40
Cost
68.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Spinal fusion172
Laminectomy or laminotomy (partial removal of spine bones)75
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
196222CAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Community Foundation Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 1, 2024 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 1, 2024 Accepting new patients
Community Foundation Medical Group CurrentSince Sep 1, 2025 Accepting new patients
Fresno Surgery Center LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

1630 E Herndon Ave
Fresno, CA 93720
Phone (559) 256-5200

2335 E Kashian Ln
Ste 270
Fresno, CA 93701
Phone (559) 445-1251

1270 E Spruce Ave
Fresno, CA 93720
Phone (559) 256-5200

10850 White Rock Rd
Rancho Cordova, CA 95670

4860 Y St
Ste 3800
Sacramento, CA 95817
Phone (916) 734-2807

4860 Y St
Sacramento, CA 95817
Phone (916) 734-2700

4860 Y St
Ste 1700
Sacramento, CA 95817
Phone (916) 734-2700

225 E Caldwell Ave
Visalia, CA 93277

Interoperability endpoints

  • Direct secure messaging: dhigginbotham4466215@direct.trinity-health.org
  • Direct secure messaging: devan.higginbotham.p1@direct.spocortho.nextgenshare.com

Organizations & group practices 8

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1555891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757635200000",
    "number": "1306409677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 E SPRUCE AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203312",
            "telephone_number": "916-734-3526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1630 E HERNDON AVE",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937203391",
            "telephone_number": "916-734-3526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGGINBOTHAM",
        "first_name": "DEVAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-22",
        "last_updated": "2025-09-12",
        "certification_date": "2025-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "CA",
            "license": "196222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

Verify at the official NPI Registry.