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JULIO R RIVERA MD
NPI 1932192929
Hospitalist in The Woodlands, TX

Active since August 25, 2005PECOS EnrolledAccepts Medicare Assignment
91.34/100
CMS Quality Rating
17521 ST LUKES WAY STE 110, THE WOODLANDS, TX 77384(936) 266-2255(936) 447-9474 Get Directions Write a Review

NPPES record last updated: August 6, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 6, 2025, Nov 15, 2022, Mar 22, 2018 (3 updates tracked since 2018).

About Julio R Rivera Md NPPES

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

JULIO R RIVERA MD (NPI 1932192929) is an individual hospitalist provider in The Woodlands, Texas, licensed in Texas (N1859) and active in the NPI registry since August 2005. He is enrolled in Medicare PECOS, is affiliated with St Luke's The Woodlands Hospital, and maintains a secondary practice location in Houston.

NPPES Registry Identity

NPI1932192929
Entity TypeIndividualMale
Primary Taxonomy208M00000X
Provider Legal NameJULIO R RIVERACredential: MD
Location Address17521 ST LUKES WAY STE 110The Woodlands, TX 77384-8041
Mailing Address17521 St Lukes Way Ste 110The Woodlands, TX 77384-8041 · (936) 266-2255 · Fax (936) 447-9474
Phone(936) 266-2255
Fax(936) 447-9474
Sole ProprietorNo
Medical School CMSOtherGraduated 1994
Enumeration DateAugust 25, 2005
Last NPPES UpdateAugust 6, 20253 updates tracked since enumeration
NPPES CertifiedAugust 6, 2025
✔ NPI 1932192929 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyHospitalistAllopathic & Osteopathic Physicians
Taxonomy Code208M00000X
License✔ Licensed in TX · N1859
Definition
Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients.
Also ListedFamily MedicineTaxonomy 207Q00000X · License 2002-0378 (NM)
Also ListedInternal MedicineTaxonomy 207R00000X · License N1859 (TX)
17521 ST LUKES WAY STE 110, The Woodlands, TX 77384
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Secondary Practice Location 1

Location 17200 Cambridge St Fl 10Houston, TX 77030-4202 · Phone (713) 798-1750 ext. 2 · Fax (713) 798-4693

Other Identifiers 4

Medicaid07187033NM
Medicaid198625901TX
Medicaid198625902TX
Medicaid198625904TX

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Julio R Rivera 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 ID2961565072
PECOS Enrollment IDI20090115000750
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Julio Rivera reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Baylor St. Luke's Medical Group
0.3 mi
Internal Medicine
17350 ST LUKES WAY STE 400
The Woodlands, TX 77384
  • Reassigned Medicare billing, Texas enrollment
  • 169 clinicians in this Medicare group
NPI 1740485879 (936) 266-3513
Baylor College Of Medicine
35 mi
Medical Genetics, Ph.D. Medical Genetics
7200 CAMBRIDGE ST FL 10
Houston, TX 77030
  • Reassigned Medicare billing, Texas enrollment
  • 2,554 clinicians in this Medicare group
NPI 1881026664 (713) 798-0000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 7

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 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.
178 services100 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.
176 services88 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.
47 services37 patients
Hospital discharge day management, 30 minutes or less 99238
Hospital discharge day management of 30 minutes or less includes finalizing your treatment, discussing your progress, and planning after-care at home. It ensures you're ready to leave the hospital and continue recovery safely.
47 services46 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.
44 services44 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.
26 services26 patients

Hospital Affiliations CMS Care Compare 3

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

St Luke's The Woodlands Hospital

Acute Care Hospitals · The Woodlands, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450862
Location17200 St Luke's WayThe Woodlands, TX 77384 · Montgomery County
Emergency services Birthing friendly

Chi St Lukes Lakeside Hospital

Acute Care Hospitals · The Woodlands, TX
OwnershipVoluntary non-profit - Other
CMS Certification Number670059
Location17400 St Lukes WayThe Woodlands, TX 77384 · Montgomery County
Emergency services

St Luke's Hospital At The Vintage

Acute Care Hospitals · Houston, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670075
Location20171 Chasewood Park DriveHouston, TX 77070 · Harris County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77384 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$97.05 typical visit price
range $17.52 – $136.11
Typical copayment $24.26 (range $4.38 – $34.02)
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.

91.34/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality81.64
Promoting Interoperability89.13
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 2

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

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier13 claims13 services$15.27 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
1 supplier13 claims13 services$64.02 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 Julio Rivera's NPI number?

The NPI number for Julio Rivera is 1932192929. It was assigned to this individual provider in the NPPES registry on August 25, 2005.

Where is Julio Rivera located?

Julio Rivera practices at 17521 St Lukes Way Ste 110, The Woodlands, TX 77384. The listed phone number is (936) 266-2255.

What is Julio Rivera's specialty?

The primary specialty registered for this NPI is Hospitalist with taxonomy code 208M00000X.

Is Julio Rivera enrolled in Medicare?

Yes. Julio Rivera 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.

Which organizations bill Medicare for Julio Rivera's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Julio Rivera reassigns Medicare benefits to 2 organizations: Baylor St. Luke's Medical Group (The Woodlands, TX) and Baylor College Of Medicine (Houston, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Julio Rivera's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Julio Rivera accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 2 other insurers list Julio Rivera 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 Rivera affiliated with any hospitals?

According to CMS data, Julio Rivera is affiliated with St Luke's The Woodlands Hospital, Chi St Lukes Lakeside Hospital and St Luke's Hospital At The Vintage.

When was this NPI record last updated?

The NPPES record for Julio Rivera was last updated on August 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.