Individual provider Active NPI

John Patrick Higinbotham, OD

  • Optometrist
  • Frederick, MD
National Provider Identifier
1952465528
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA1174 Issued in MD
Practice address
1202 E Patrick St Ste 4
Frederick, MD 21701-3167
Phone
(301) 663-8858
Fax
(301) 663-8871
NPI assigned
Dec 20, 2006
Last updated
Feb 20, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA1174 MD Primary

Addresses

Primary practice location

1202 E Patrick St Ste 4
Frederick, MD 21701-3167

Mailing address

1202 E Patrick St Ste 4
Frederick, MD 21701-3167
Phone (301) 663-8858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070521000407 MD Practitioner - Optometry 8729185079 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1202 E Patrick St
Suite 4
Frederick, MD 21701-3167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
TA1174MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Fredericktowne Eye Care John Higinbotham OD PA Optometrist CurrentSince Jan 12, 1999 Accepting new patients
Linganore Medical Practice, LLC CurrentSince Nov 29, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

1202 E Patrick St
Ste 4
Frederick, MD 21701
Phone (240) 422-3971

467 W Patrick St
Frederick, MD 21701
Phone (301) 663-8858

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1952465528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 E PATRICK ST STE 4",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013167",
            "telephone_number": "301-663-8858",
            "fax_number": "301-663-8871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 E PATRICK ST STE 4",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013167",
            "telephone_number": "301-663-8858",
            "fax_number": "301-663-8871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIGINBOTHAM",
        "first_name": "JOHN",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA1174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.