Individual provider Active NPI

Julia McDougal Ronconi, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Brattleboro, VT
National Provider Identifier
1003886599
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN2295461 Issued in MA
Practice address
130 Austine Dr
Brattleboro, VT 05301-7040
Phone
(802) 380-1971
Fax
(802) 419-3844
NPI assigned
Jan 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3336954405 UT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 101.0886663 VT
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 101.0086663 VT
Adult Psychiatric/Mental Health Clinical Nurse Specialist 364SP0809X RN2295461 MA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN2295461 MA Primary

Addresses

Primary practice location

130 Austine Dr
Brattleboro, VT 05301-7040

Mailing address

160 Guilford St
Brattleboro, VT 05301-6295
Phone (802) 380-1971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150203000321 MA Practitioner - Certified Clinical Nurse Specialist (CNS) 7214032705 Reassigns benefits to 1 organization
I20241223000684 MA Practitioner - Nurse Practitioner 7214032705 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Supportive Behavioral Care of Ma LLCGroup PAC ID 8628346731, 103 clinicians

Practice addresses (Care Compare)

44 School St
Boston, MA 02108-4209
Phone (718) 298-4375

Merit-based Incentive Payment System (MIPS)

Final score
86.67 of 100Reported as group
Quality
71.18
Improvement activities
40
Cost
75.07

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN2295461MAMDPsychiatric/Mental Health Nurse Practitioner
3336954405UTMDPsychiatric/Mental Health Nurse Practitioner
101.0886663VTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Behavioral Care of Ma LLC CurrentSince Oct 14, 2024 Accepting new patients
University of Utah Medical Center Psychiatry Past Accepting new patients

Locations

44 School St
Rm 325
Boston, MA 02108
Phone (508) 831-8558

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1003886599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 GUILFORD ST",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053016295",
            "telephone_number": "802-380-1971",
            "fax_number": "802-419-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 AUSTINE DR",
            "city": "BRATTLEBORO",
            "state": "VT",
            "postal_code": "053017040",
            "telephone_number": "802-380-1971",
            "fax_number": "802-419-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDOUGAL RONCONI",
        "first_name": "JULIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "3336954405",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0886663",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VT",
            "license": "101.0086663",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MA",
            "license": "RN2295461",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN2295461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brattleboro, VT

Sources for this page

Verify at the official NPI Registry.