NPIMap

Individual provider Active NPI

Julio Enrique Montejo, D.O.

  • Family Medicine Physician
  • Tierra Verde, FL
National Provider Identifier
1346488558
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 10388 Issued in FL
Practice address
1120 Pinellas Bayway S
Suite 200
Tierra Verde, FL 33715-1543
Phone
(727) 867-5480
Fax
(727) 867-5470
NPI assigned
Jan 26, 2009
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OS 10388 FL Primary

Addresses

Primary practice location

1120 Pinellas Bayway S
Suite 200
Tierra Verde, FL 33715-1543

Mailing address

1120 Pinellas Bayway S
Suite 200
Tierra Verde, FL 33715-1543
Phone (727) 867-5480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091030000190 FL Practitioner - Family PracticePractitioner - Emergency Medicine 0042357691 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1000 NE 56TH St
Holy Cross Wound Care Center
Fort Lauderdale, FL 33334-4149
Phone (954) 202-4877

3000 Coral Hills Dr
Coral Springs, FL 33065-4108
Phone (954) 344-3206

5072 Stillwater Ter
Cooper City, FL 33330-2755

6401 N Federal Hwy
Fort Lauderdale, FL 33308-1427
Phone (954) 776-8921

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue598
Removal of skin lesions131
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS 10388FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Julio Montejo DO PA Family Medicine CurrentSince Jun 18, 2012 Accepting new patients
Nautilus Health Care Group, LLC Past Accepting new patients
Advanced Wound Systems LLC Past Accepting new patients

Locations

6401 N Federal Hwy
Ft Lauderdale, FL 33308
Phone (954) 776-8500

1000 NE 56th St
Oakland Park, FL 33334
Phone (954) 229-8608

3000 Coral Hills Dr
Pompano Beach, FL 33065
Phone (954) 344-3000

Interoperability endpoints

  • Direct secure messaging: jmontejo2012635@direct.trinity-health.org

Organizations & group practices 3

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

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1232928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1346488558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 PINELLAS BAYWAY S",
            "address_2": "SUITE 200",
            "city": "TIERRA VERDE",
            "state": "FL",
            "postal_code": "337151543",
            "telephone_number": "727-867-5480",
            "fax_number": "727-867-5470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 PINELLAS BAYWAY S",
            "address_2": "SUITE 200",
            "city": "TIERRA VERDE",
            "state": "FL",
            "postal_code": "337151543",
            "telephone_number": "727-867-5480",
            "fax_number": "727-867-5470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONTEJO",
        "first_name": "JULIO",
        "middle_name": "ENRIQUE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-26",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 10388",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tierra Verde, FL

Sources for this page

Verify at the official NPI Registry.