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RICHARD VALENZUELA MD
NPI 1174591424
Family Medicine in Jacksonville, FL

Active since March 11, 2006PECOS EnrolledAccepts Medicare Assignment
91.62/100
CMS Quality Rating
5491 DOLPHIN POINT BLVD STE 3110, JACKSONVILLE, FL 32211(904) 744-5244(904) 390-7474 Get Directions Write a Review

NPPES record last updated: December 23, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 23, 2024, Dec 21, 2018, Nov 17, 2015 and 1 more (4 updates tracked since 2015).

About Richard Valenzuela Md NPPES

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

RICHARD VALENZUELA MD (NPI 1174591424) is an individual family medicine provider in Jacksonville, Florida, licensed in Florida (ME90216) and active in the NPI registry since March 2006. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (1999).

NPPES Registry Identity

NPI1174591424
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameRICHARD VALENZUELACredential: MD
Location Address5491 DOLPHIN POINT BLVD STE 3110Jacksonville, FL 32211-3221
Mailing AddressPo Box 45443Salt Lake City, UT 84145-0443 · (904) 202-1032 · Fax (904) 376-4107
Phone(904) 744-5244
Fax(904) 390-7474
Sole ProprietorNo
Medical School CMSOtherGraduated 1999
Enumeration DateMarch 11, 2006
Last NPPES UpdateDecember 23, 20244 updates tracked since enumeration
NPPES CertifiedDecember 23, 2024
✔ NPI 1174591424 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in FL · ME90216
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

5491 DOLPHIN POINT BLVD STE 3110, Jacksonville, FL 32211
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Other Identifiers 1

OtherP00141042FL · Railroad Medicare

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company).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

Richard Valenzuela Md 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 ID2163497363
PECOS Enrollment IDI20040831001234
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 9

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.

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.
303 services181 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
180 services180 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
153 services130 patients
Injection of drug or substance under skin or into muscle 96372
This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.
60 services36 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.
48 services35 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
36 services28 patients

Hospital Affiliations CMS Care Compare 4

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100088
Location800 Prudential DrJacksonville, FL 32207 · Duval County
Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100117
Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County
Emergency services Birthing friendly

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number100140
Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County
Emergency services

Hca Florida Memorial Hospital

Acute Care Hospitals · Jacksonville, FL
2/5 CMS rating
OwnershipProprietary
CMS Certification Number100179
Location3625 University Blvd SJacksonville, FL 32216 · Duval County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32211 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

91.62/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality77.61
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 4

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
10 suppliers23 claims66 services$6.71 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers36 claims36 services$64.82 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
4 suppliers17 claims19 services$185.21 avg. paid by Medicare
Portable gaseous oxygen system, rental; home compressor used to fill portable oxygen cylinders; includes portable containers, regulator, flowmeter, humidifier, cannula or mask, and tubing K0738
DME-Oxygen and Supplies · category DC000N
1 supplier12 claims12 services$30.92 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

DANA YVONNE PRESTON PHD, APRN, - C.S
Nurse Practitioner
5491 DOLPHIN POINT BLVD STE 3110
JACKSONVILLE, FL 32211
Duval County (904) 744-5244
BAPTIST PRIMARY CARE INC
Family Medicine
5491 DOLPHIN POINT BLVD STE 3110
JACKSONVILLE, FL 32211
Duval County (904) 744-5244
FARA NADAL MD
Family Medicine
5491 DOLPHIN POINT BLVD STE 3110
JACKSONVILLE, FL 32211
Duval County (904) 744-5244
RABEYA NAZER
Nurse Practitioner (Family)
5491 DOLPHIN POINT BLVD STE 3110
JACKSONVILLE, FL 32211
Duval County (904) 744-5244

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 Richard Valenzuela's NPI number?

The NPI number for Richard Valenzuela is 1174591424. It was assigned to this individual provider in the NPPES registry on March 11, 2006.

Where is Richard Valenzuela located?

Richard Valenzuela practices at 5491 Dolphin Point Blvd Ste 3110, Jacksonville, FL 32211. The listed phone number is (904) 744-5244.

What is Richard Valenzuela's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Richard Valenzuela enrolled in Medicare?

Yes. Richard Valenzuela 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 Richard Valenzuela accept?

Health plans from AvMed, Florida Blue (BlueCross BlueShield FL) and Florida Blue HMO (a BlueCross BlueShield FL company) list Richard Valenzuela 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 Richard Valenzuela affiliated with any hospitals?

According to CMS data, Richard Valenzuela is affiliated with Baptist Health Medical Center - Jacksonville, Baptist Medical Center Beaches, Baptist Medical Center - Nassau and Hca Florida Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Richard Valenzuela was last updated on December 23, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.