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DR. MIGUEL F ROURA M.D.
NPI 1518961085
Internal Medicine - Endocrinology, Diabetes & Metabolism in Jacksonville, FL

Active since June 13, 2005PECOS EnrolledAccepts Medicare Assignment
91.62/100
CMS Quality Rating
3813 SILVERPOINT LN, JACKSONVILLE, FL 32216(904) 607-7475 Get Directions Write a Review

NPPES record last updated: July 10, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Jul 10, 2026, Feb 4, 2025 (2 updates tracked since 2025).

About Dr. Miguel F Roura M.d. NPPES

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

DR. MIGUEL F ROURA M.D. (NPI 1518961085) is an individual endocrinology, diabetes & metabolism provider in Jacksonville, Florida, licensed in Florida (ME50092) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of University Central Del Caribe Escuela De Medicina (1981).

NPPES Registry Identity

NPI1518961085
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. MIGUEL F ROURACredential: M.D.
Location Address3813 SILVERPOINT LNJacksonville, FL 32216-1417
Mailing Address3813 Silverpoint LnJacksonville, FL 32216-1417 · (904) 607-7475
Phone(904) 607-7475
Sole ProprietorNo
Medical School CMSUniversity Central Del Caribe Escuela De MedicinaGraduated 1981
Enumeration DateJune 13, 2005
Last NPPES UpdateJuly 10, 20262 updates tracked since enumeration
NPPES CertifiedJuly 10, 2026
✔ NPI 1518961085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in FL · ME50092
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedSpecialistTaxonomy 174400000X · License ME50092 (FL)
Also ListedInternal MedicineTaxonomy 207R00000X · License ME50092 (FL)
3813 SILVERPOINT LN, Jacksonville, FL 32216
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Other Identifiers 1

Medicaid371201000FL

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

Dr. Miguel F Roura 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 ID446392302
PECOS Enrollment IDI20100115000421
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 8

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.
529 services308 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
222 services69 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.
181 services67 patients
Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251
This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.
84 services44 patients
Ultrasound scan of head and neck soft tissue 76536
An ultrasound scan of the head and neck soft tissue is a non-invasive procedure that uses sound waves to create images of the soft tissues in these areas. It helps identify any abnormalities or issues, such as tumors, cysts, or infections. It's painless and doesn't involve radiation.
71 services68 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.
62 services58 patients

Hospital Affiliations CMS Care Compare

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32216 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
$130.04 typical visit price
range $56.00 – $171.84
Typical copayment $32.51 (range $14.00 – $42.96)
Most-billed visit code 99204
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 11

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

Supplies for maintenance of insulin infusion catheter, per week A4224
DME-Other DME · category DE017N
6 suppliers51 claims684 services$17.99 avg. paid by Medicare
Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225
DME-Other DME · category DE017N
6 suppliers51 claims1,700 services$2.32 avg. paid by Medicare
Supply allowance for adjunctive continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service A4238
DME-Medical/Surgical Supplies · category DA000N
3 suppliers16 claims16 services$172.23 avg. paid by Medicare
Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
46 suppliers166 claims640 services$6.28 avg. paid by Medicare
Normal, low and high calibrator solution / chips A4256
DME-Other DME · category DE000N
5 suppliers26 claims26 services$2.94 avg. paid by Medicare
Spring-powered device for lancet, each A4258
DME-Other DME · category DE000N
3 suppliers11 claims11 services$1.83 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Miguel Roura's NPI number?

The NPI number for Miguel Roura is 1518961085. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Miguel Roura located?

Miguel Roura practices at 3813 Silverpoint Ln, Jacksonville, FL 32216. The listed phone number is (904) 607-7475.

What is Miguel Roura's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Miguel Roura enrolled in Medicare?

Yes. Miguel Roura 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 Miguel Roura accept?

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

According to CMS data, Miguel Roura is affiliated with Baptist Health Medical Center - Jacksonville.

When was this NPI record last updated?

The NPPES record for Miguel Roura was last updated on July 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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.