DR. JULIO G VENTURA MD
NPI 1164659546
Psychiatry & Neurology - Neurology in Middleburg, FL

NPI Status: Active since June 12, 2009

Contact Information

1658 ST VINCENTS WAY STE 310
MIDDLEBURG, FL
ZIP 32068
Phone: (904) 602-4450
Fax: (904) 602-4449

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  • Individual
  • Male
  • Years of Experience 18
  • Psychiatry & Neurology
  • Neurology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled
  • Medicare Quality Reporting

About JULIO VENTURA

This page provides the complete NPI Profile along with additional information for Julio Ventura, a provider established in Middleburg, Florida with a medical specialization in Psychiatry & Neurology, focusing in neurology and more than 18 years of experience. The healthcare provider is registered in the NPI registry with number 1164659546 assigned on June 2009. The practitioner's primary taxonomy code is 2084N0400X with license number ME114633 (FL). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1164659546
Provider Name
DR. JULIO G VENTURA MD
Gender
Male
Entity Type
Individual
Location Address
1658 ST VINCENTS WAY STE 310 MIDDLEBURG, FL 32068
Location Phone
(904) 602-4450
Location Fax
(904) 602-4449
Mailing Address
4205 BELFORT RD STE 4015 JACKSONVILLE, FL 32216
Medical School Name
OTHER
Graduation Year
2008
Is Sole Proprietor?
No
Enumeration Date
06-12-2009
Last Update Date
06-12-2023
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Location Map

Secondary Locations

  • 11215 Metro Pkwy Ste 1
    Fort Myers, FL 33966
    (239) 208-2206

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Psychiatry & Neurology Neurology

Taxonomy Code
2084N0400X
Type
Allopathic & Osteopathic Physicians
License No.
ME114633
License State
FL
Taxonomy Description
A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • Blue Focus Bronze POS? 205 - POS
  • Blue Focus Bronze POS? 705 - POS
  • Blue Focus Bronze POS? Standard - POS
  • Blue Focus Gold POS? 207 - POS
  • Blue Focus Gold POS? 902 - POS
  • Blue Focus Gold POS? Standard - POS
  • Blue Focus Silver POS? 206 - POS
  • Blue Focus Silver POS? 903 - POS
  • Blue Focus Silver POS? Standard - POS
  • Blue Preferred Bronze PPO? 201 - PPO
  • AZ Blue AdvanceHealth Bronze Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Bronze Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Gold Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Focus (4 Free PCP Visits) - HMO
  • AZ Blue AdvanceHealth Silver Neighborhood (4 Free PCP Visits) - HMO
  • AZ Blue EverydayHealth Gold Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Gold Neighborhood (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Focus (1 Free PCP Visit) - HMO
  • AZ Blue EverydayHealth Silver Neighborhood (1 Free PCP Visit) - HMO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • CHRISTUS Bronze (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential - HMO
  • CHRISTUS Bronze Essential (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential + Dental & Vision (2 Free PCP Visits, $0 Preferred Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Bronze Essential Plus - HMO
  • CHRISTUS Catastrophic (3 Free PCP visits) - HMO
  • CHRISTUS Gold - HMO
  • CHRISTUS Gold + Dental & Vision + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
  • CHRISTUS Gold + Fitness ($0 Deductible, $5 PCP, $0 Generic Rx, $0 Virtual Urgent Care) - HMO
  • Molina Bronze Enhanced 3500 - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Enhanced 3500 Plus with Adult Vision - HMO
  • Molina Bronze Saver 7000 - HMO
  • Molina Bronze Saver 7000 Plus with Adult Dental and Vision - HMO
  • Molina Bronze Saver 7000 Plus with Adult Vision - HMO
  • Molina Bronze Smart Heart Health - HMO
  • Molina Bronze Standard - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
016457500MEDICAID (05)FL 

Medicare Participation & PECOS Enrollment Status

Julio Ventura is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Julio Ventura is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2163662495

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20130723000638, I20230628004119

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Established patient office or other outpatient visit, 30-39 minutes

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.

This service was performed 19 times for 16 patients

Established patient office or other outpatient visit, 40-54 minutes

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.

This service was performed 22 times for 22 patients

Follow-up hospital inpatient care per day, typically 25 minutes

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.

This service was performed 232 times for 121 patients

Follow-up hospital inpatient care per day, typically 35 minutes

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.

This service was performed 243 times for 122 patients

Initial hospital inpatient care per day, typically 50 minutes

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.

This service was performed 85 times for 84 patients

Initial hospital inpatient care per day, typically 70 minutes

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.

This service was performed 181 times for 171 patients

New patient office or other outpatient visit, 45-59 minutes

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.

This service was performed 25 times for 25 patients

New patient office or other outpatient visit, 60-74 minutes

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

This service was performed 18 times for 18 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $32.51 for a new patient copayment and $24.79 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 32068 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

  • Average New Patient Price $130.04
  • Minimum New Patient Price $56
  • Maximum New Patient Price $171.84
  • Average New Patient Copayment $32.51
  • Minimum New Patient Copayment $14
  • Maximum New Patient Copayment $42.96

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.16
  • Minimum Established Patient Price $17.57
  • Maximum Established Patient Price $139.16
  • Average Established Patient Copayment $24.79
  • Minimum Established Patient Copayment $4.39
  • Maximum Established Patient Copayment $34.79

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure Performance Number of Patients
Chronic Care and Preventative Care Management for Empaneled PatientsYesN/A
Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation.
Closing the Referral Loop: Receipt of Specialist Report 27% 358
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Dementia: Cognitive Assessment 10% 71
Percentage of patients, regardless of age, with a diagnosis of dementia for whom an assessment of cognition is performed and the results reviewed at least once within a 12-month period
Documentation of Current Medications in the Medical Record 95% 1573
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. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing 93% 920
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Health Information Exchange 49% 443
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Implementation of medication management practice improvementsYesN/A
Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews.
Measurement and Improvement at the Practice and Panel LevelYesN/A
Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level.
Medication Reconciliation 99% 537
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.
Patient-Specific Education 48% 956
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan 56% 844
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 twelve months of the current encounter Normal Parameters: Age 18 years and older BMI >= 18.5 and < 25 kg/m2
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention 86% 464
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Provide Patient Access 82% 956
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 certain information.
Secure Messaging 33% 956
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 message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk AnalysisYesN/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry ReportingYesN/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of decision support and standardized treatment protocolsYesN/A
Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Julio Ventura is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
CHRISTUS GOOD SHEPHERD MEDICAL CENTER700 E MARSHALL AVE
LONGVIEW, TX 75601
(903) 927-6712Acute Care Hospitals
CHRISTUS SOUTHEAST TEXAS- ST ELIZABETH2830 CALDER AVENUE
BEAUMONT, TX 77702
(409) 892-7171Acute Care Hospitals
CHRISTUS SANTA ROSA HOSPITAL-SAN MARCOS1301 WONDER WORLD DRIVE
SAN MARCOS, TX 78666
(512) 753-3690Acute Care Hospitals
CHRISTUS JASPER MEMORIAL HOSPITAL1275 MARVIN HANCOCK DRIVE
JASPER, TX 75951
(409) 384-5461Acute Care Hospitals
CHRISTUS ST MICHAEL HEALTH SYSTEM2600 ST MICHAEL DR
TEXARKANA, TX 75503
(903) 614-1000Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1164659546, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
4
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
5
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
5
Unchanged
Pos 9
4
Doubled → 8
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 6 → 12 → 3 9 → 18 → 9 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 2 + 4 + 1 + 2 + 5 + 1 + 8 + 5 + 8 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1164659546.

Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Nurse Practitioner (Family)
1658 ST VINCENTS WAY STE 310
MIDDLEBURG, FL 32068

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1164659546, enumerated as an "individual" on June 12, 2009.

The provider is located at 1658 ST VINCENTS WAY STE 310 MIDDLEBURG, FL 32068 and the phone number is (904) 602-4450.

Psychiatry & Neurology with taxonomy code 2084N0400X and a focus in Neurology.

The provider might be accepting Accepts: AvMed, Blue Cross and Blue Shield of Montana, Blue. Please consult your insurance carrier or call the provider to verify.

Julio Ventura is affiliated with: CHRISTUS GOOD SHEPHERD MEDICAL CENTER, CHRISTUS SOUTHEAST TEXAS- ST ELIZABETH, CHRISTUS SANTA ROSA HOSPITAL-SAN MARCOS, CHRISTUS JASPER MEMORIAL HOSPITAL and CHRISTUS ST MICHAEL HEALTH SYSTEM.