JULIO ERNESTO PENA M.D.
NPI 1073891198
Internal Medicine - Nephrology in Watkinsville, GA

Q: What is Julio Pena's NPI number?

The NPI number for Julio Pena is 1073891198. It was assigned to this individual provider in the NPPES registry on July 22, 2011.

Q: What is Julio Pena's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Q: When was this NPI record last updated?

The NPPES record for Julio Pena was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 22, 2011PECOS EnrolledAccepts Medicare Assignment

1360 CADUCEUS WAY, BLDG 400, SUITE 104, WATKINSVILLE, GA 30677(706) 850-8135(706) 548-9101 Get Directions Write a Review

NPPES record last updated: July 18, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Julio Ernesto Pena M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JULIO ERNESTO PENA M.D. (NPI 1073891198) is an individual nephrology provider in Watkinsville, Georgia, licensed in Georgia (75119) and active in the NPI registry since July 2011. He is enrolled in Medicare PECOS, is affiliated with St Mary's Hospital, and is a graduate of Other (2008).

NPPES Registry Identity

NPI1073891198

Entity TypeIndividualMale

Primary Taxonomy207RN0300X

Provider Legal NameJULIO ERNESTO PENACredential: M.D.

Location Address1360 CADUCEUS WAY, BLDG 400, SUITE 104Watkinsville, GA 30677-7300

Mailing Address1360 Caduceus Way, Bldg 400, Suite 104Watkinsville, GA 30677-7300 · (706) 850-8135 · Fax (706) 548-9101

Phone(706) 850-8135

Fax(706) 548-9101

Sole ProprietorNo

Medical School CMSOtherGraduated 2008

Enumeration DateJuly 22, 2011

Last NPPES UpdateJuly 18, 2016

✔ NPI 1073891198 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code207RN0300X

License✔ Licensed in GA · 75119

Definition

An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

1360 CADUCEUS WAY, Watkinsville, GA 30677

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Julio Ernesto Pena M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5294028429

PECOS Enrollment IDI20160726002622

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

406 services149 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

366 services296 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

263 services187 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

262 services148 patients

Dialysis services, 4 or more physician visits per month (20 years or older) 90960

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys can't do their job. This service includes 4 or more visits per month with a physician to monitor your health and adjust your treatment as needed.

112 services47 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

102 services93 patients

Dialysis services, 2-3 physician visits per month (20 years or older) 90961

Dialysis is a treatment that performs the function of healthy kidneys if they're not working properly. It removes waste and excess fluid from your blood. 2-3 physician visits per month are recommended for monitoring your health and adjusting your treatment as needed. This service is available for those aged 20 years and older.

62 services34 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

59 services54 patients

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

57 services32 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

44 services44 patients

Dialysis services, 1 physician visit per month (20 years or older) 90962

Dialysis is a treatment that filters and purifies your blood using a machine. It helps keep your fluids and electrolytes in balance when the kidneys canâ€™t do their job. A physician visit once a month ensures your treatment is working effectively and adjusts it if necessary. This service is available for individuals aged 20 years and older.

37 services22 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

36 services28 patients

Hemodialysis procedure with physician evaluation 90935

Hemodialysis is a treatment that uses a machine to filter waste and excess fluid from your blood when your kidneys can't. A physician checks your health before, during, and after the procedure to ensure it's working effectively for you.

31 services23 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Mary's Hospital

Acute Care Hospitals · Athens, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110006

Location1230 Baxter StreetAthens, GA 30606 · Clarke County

Emergency services Birthing friendly

Piedmont Newton Hospital

Acute Care Hospitals · Covington, GA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110018

Location5126 Hospital Drive NECovington, GA 30014 · Newton County

Emergency services Birthing friendly

Piedmont Walton Hospital

Acute Care Hospitals · Monroe, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number110046

Location2151 W Spring StreetMonroe, GA 30655 · Walton County

Emergency services Birthing friendly

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110074

Location1199 Prince AvenueAthens, GA 30606 · Clarke County

Birthing friendly

St. Mary's Good Samaritan Hospital

Critical Access Hospitals · Greensboro, GA

4/5 CMS rating

OwnershipProprietary

CMS Certification Number111329

Location5401 Lake Oconee ParkwayGreensboro, GA 30642 · Greene County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30677 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$124.10 typical visit price

range $53.31 – $164.04

Typical copayment $31.02 (range $13.32 – $41.01)

Most-billed visit code 99204

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,291 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

64%245 patients3/55-star benchmark: 100%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

84%25 patients4/55-star benchmark: 100%

Pneumococcal Vaccination Status for Older Adults

Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine

84%253 patients4/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

99%765 patients4/55-star benchmark: 100%

Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling

Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user

45%323 patients2/55-star benchmark: 100%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

94%186 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

31%186 patients2/55-star benchmark: 79%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AOA HEARING AIDS

Audiologist

1360 CADUCEUS WAY, BUILDING 200, SUITE 101
WATKINSVILLE, GA 30677

Oconee County (706) 310-7115

DR. KAITLIN THRIFT DMD

Dentist (General Practice)

1360 CADUCEUS WAY
WATKINSVILLE, GA 30677

Oconee County (706) 715-0229

DR. RICHARD C MANUS JR. D.M.D.

Dentist (Oral and Maxillofacial Surgery)

1360 CADUCEUS WAY, BUILDING 500 SUITE 101
WATKINSVILLE, GA 30677

Oconee County (706) 548-0604

DR. KENNETH BRADLEY HALL DMD

Dentist

1360 CADUCEUS WAY, BLDG 900 STE 101
WATKINSVILLE, GA 30677

Oconee County (706) 543-3629

HALEE WRIGHT GRIFFITH NP

Nurse Practitioner (Family)

1360 CADUCEUS WAY
WATKINSVILLE, GA 30677

Oconee County (706) 850-8135

CHANDLER GROVE

Dentist (General Practice)

1360 CADUCEUS WAY
WATKINSVILLE, GA 30677

Oconee County (706) 543-3629

KARA HESTER JOHNSON DMD

Dentist (General Practice)

1360 CADUCEUS WAY
WATKINSVILLE, GA 30677

Oconee County (706) 543-3629

ELIZABETH SCOTT RBT

Behavior Technician

1360 CADUCEUS WAY, BUILDING 600 STE 101
WATKINSVILLE, GA 30677

Oconee County (762) 499-3476

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Julio Pena's NPI number?

The NPI number for Julio Pena is 1073891198. It was assigned to this individual provider in the NPPES registry on July 22, 2011.

Where is Julio Pena located?

Julio Pena practices at 1360 Caduceus Way Bldg 400, Suite 104, Watkinsville, GA 30677. The listed phone number is (706) 850-8135.

What is Julio Pena's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Nephrology, with taxonomy code 207RN0300X.

Is Julio Pena enrolled in Medicare?

Yes. Julio Pena is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Julio Pena accept?

Health plans from Alliant Health Plans, Inc. list Julio Pena as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Julio Pena affiliated with any hospitals?

According to CMS data, Julio Pena is affiliated with St Mary's Hospital, Piedmont Newton Hospital, Piedmont Walton Hospital, Piedmont Athens Regional Medical Center and St. Mary's Good Samaritan Hospital.

When was this NPI record last updated?

The NPPES record for Julio Pena was last updated on July 18, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.