Loretta A Higgins , NP
Nurse Practitioner • Dover, DE
530 S State St Ste 107
Dover, DE 199013562
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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Loretta Higgins is listed in NPPES under Nurse Practitioner.
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NPI assigned on May 27, 2005; this date does not establish years in practice.
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Published CMS data list 475 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99222 — Initial hospital care with straightforward or low-level medical decision making: 141 service units.
- 99221 — Initial hospital care with straightforward or low level of medical decision making, per day: 112 service units.
- 99232 — Subsequent hospital care with moderate levelof medical decision making: 91 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 6 records in the table · Guide: How to read Medicare Part B data
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More Medicare Part B services than 75% of clinicians listed under Nurse Practitioner in Dover, DE (2024, 33 clinicians with data). Median for this group: 311. Middle half: 105 to 475.
Close to the middle for Medicare Part B services among clinicians listed under Nurse Practitioner in Delaware (2024, 220 clinicians with data). Median for this group: 372. Middle half: 118 to 824.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 32 in 2018 to 475 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2018–2024.
Practice Location & Contact Primary Location
530 S State St Ste 107
Dover, DE 199013562
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Nurse Practitioner: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
300 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $42,729 in 2024
The total amount Medicare approved for these services in 2024. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Paid by Medicare
About $32,838 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024.
Open Payments general payments, program year 2025
All general payments: $40.37 across 2 records.
By nature of payment
- Food and Beverage: $40.37 across 2 records.
Reporting-company totals
- Boston Scientific Corporation: $22.75 across 1 record.
- HOLOGIC INC: $17.62 across 1 record.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2025 (published June 30, 2026).
NPI first issued
2005
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Loretta Higgins has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Loretta Higgins as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Dover and Delaware
Billing and prescribing volume is not a quality rating.
Medicare Part B services
More Medicare Part B services than 75% of clinicians listed under Nurse Practitioner in Dover, DE (2024, 33 clinicians with data). Median for this group: 311. Middle half: 105 to 475.
Close to the middle for clinicians listed under Nurse Practitioner in Delaware (2024, 220 clinicians with data). Median for this group: 372. Middle half: 118 to 824.
Medicare-allowed amount
A higher Medicare-allowed amount than 80% of clinicians listed under Nurse Practitioner in Dover, DE (2024, 33 clinicians with data). Median for this group: $18,970. Middle half: $6,598 to $36,650.
A higher Medicare-allowed amount than 65% of clinicians listed under Nurse Practitioner in Delaware (2024, 220 clinicians with data). Median for this group: $27,904. Middle half: $10,080 to $59,546.
Paid by Medicare
A higher Medicare payment amount than 80% of clinicians listed under Nurse Practitioner in Dover, DE (2024, 33 clinicians with data). Median for this group: $13,839. Middle half: $4,938 to $26,856.
A higher Medicare payment amount than 65% of clinicians listed under Nurse Practitioner in Delaware (2024, 220 clinicians with data). Median for this group: $20,169. Middle half: $7,749 to $44,071.
59 active clinicians are listed under Nurse Practitioner with a practice address in Dover, DE (547 in Delaware).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Dover
8.5% of these 59 clinicians have the CMS telehealth indicator.
69.5% of these 59 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services increased 1384% from 32 in 2018 to 475 in 2024.
- 2018: 32
- 2021: 56
- 2022: 861
- 2023: 482
- 2024: 475
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Medicare-allowed amount
Medicare-allowed amount increased 879% from $4,363 in 2018 to $42,729 in 2024.
- 2018: $4,363
- 2021: $5,926
- 2022: $75,107
- 2023: $48,392
- 2024: $42,729
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Paid by Medicare
Paid by Medicare increased 926% from $3,201 in 2018 to $32,838 in 2024.
- 2018: $3,201
- 2021: $4,741
- 2022: $59,249
- 2023: $37,611
- 2024: $32,838
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Industry payments (Open Payments)
CMS data for industry payments (Open Payments) are available for 2025 only.
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Open Payments (2025), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2025 (payments made January 1 – December 31, 2025): fewer than 11 records totaling $40.37.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Boston Scientific Corporation |
Food and Beverage
In-kind items and services
|
AMS 700 | General | $22.75 |
| HOLOGIC INC |
Food and Beverage
In-kind items and services
|
MYOSURE TISSUE REMOVAL DEVICE | General | $17.62 |
Source: CMS Open Payments, program year 2025, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2023 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2024; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99222
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes
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141 | 131 | $583.16 | $107.71 |
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99221
Initial hospital care with straightforward or low level of medical decision making, per day, if using time, at least 40 minutes
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112 | 103 | $352.11 | $68.44 |
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99232
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes
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91 | 70 | $264.43 | $64.68 |
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99223
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes
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62 | 60 | $701.29 | $142.38 |
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99233
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes
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41 | 36 | $377.49 | $98.02 |
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99231
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes
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28 | 24 | $146.50 | $40.86 |
Source: CMS Part B by Provider and Service, 2024; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2023-09-21NUCC Taxonomy Code: 363L00000X
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - NURSE PRACTITIONER
I20031125000214
DE
8426952086
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Internal Medicine - Critical Care Medicine
Doctor of Medicine (M.D.)
Nurse Practitioner
Certified Registered Nurse Practitioner
Nurse Practitioner
Nurse Practitioner (Certified)
Clinical Nurse Specialist
AGCNSBC
Career & Practice History Timeline
Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status
Registered at 530 S STATE ST STE 107, DOVER, DE 199013562 (Tel: 3026085299)
Registered at 640 S STATE ST, MAIL CODE 3055, DOVER, DE 199013530 (Tel: 3024801688)
Registered at 640 S STATE ST, DOVER, DE 199013530 (Tel: 3027446584)
Registered at 640 S STATE ST, DOVER, DE 199013530 (Tel: 3024801688)
NPI status registered as active in NPPES database
Registered at 34431 KING STREET ROW, LEWES, DE 199584787 (Tel: 3026452666)
Registered at 34431 KING STREET ROW, LEWES, DE 199584787 (Tel: 3026452666)
Recorded as LORETTA HIGGINS, NP
Nurse Practitioner (license number reported to NPPES: DE LD-0000109)
First registered as active Individual Practitioner in NPPES Database.
NPI Administrative Meta
Other Nurse Practitioners in Dover
- Jayne Murphy, NP
- Kelly Ryan, APRN, FNP-C
- Dr. Tricia Delnay, ACNP-BC, DNP
- Rosemary Ongaki, NP-C
- Matthew Fuchs, NP
- Timothy Eden, AGACNP-BC
Mailing Address
640 S State St, Mail Code 3055
Dover, DE 199013530
Phone: 3024801688