Individual provider Active NPI

Ivette M Sosa Seda, M.D.

  • Dermatology Physician
  • St Augustine, FL
National Provider Identifier
1225287576
Registry record updated Sep 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
ME133840 Issued in FL
Practice address
1100 S Ponce de Leon Blvd Ste 3B
St Augustine, FL 32084-6013
Phone
(813) 321-1786
Fax
(813) 321-1787
NPI assigned
Sep 11, 2008
Last updated
Sep 14, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 17959 PR
Dermatology Physician 207N00000X ME133840 FL Primary

Addresses

Primary practice location

1100 S Ponce de Leon Blvd Ste 3B
St Augustine, FL 32084-6013

Mailing address

18228 N US Highway 41
Lutz, FL 33549-4400
Phone (813) 321-1786

Other practice location 1

3200 3rd St S
Jacksonville Beach, FL 32250-6096
Phone (813) 321-1786

Other practice location 2

Urb Industrial Reparada 2 396 Dr Luis F Sala
Ponce, PR 00716-7004
Phone (787) 840-2317 ext. 5835

Other names 1

  • Ivette Marie Sosa-Seda Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114002717 FL Practitioner - Dermatology 7416105879 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
University of Puerto Rico School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18228 N US Hwy 41
Lutz, FL 33549-4400

4414 Hunterston LN
Jacksonville, FL 32224-7629

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.5 of 100Reported as group
Quality
100
Improvement activities
40
Cost
61.65

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision15
Removal of skin lesions795
Removal or shaving of skin growth15
Skin biopsy379

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17959PRMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Avenue Dermatology PA Dermatology CurrentSince Feb 13, 2024 Accepting new patients
Florida ENT Associates, Inc. PastSince Sep 15, 2021 Accepting new patients
Mary E. Schmieder DO. Facep, Inc Past Accepting new patients
Suncoast Skin Solutions Dermatology PastSince Oct 21, 2025 Accepting new patients

Locations

15255 Max Leggett Pkwy
Ste 5000
Jacksonville, FL 32218
Phone (904) 541-0315

15255 Max Leggett Pkwy
Ste 5100
Jacksonville, FL 32218
Phone (904) 541-0315

1543 Kingsley Ave
Ste 16
Orange Park, FL 32073
Phone (904) 278-2246

1677 Eagle Harbor Pkwy
Ste B
Orange Park, FL 32003
Phone (904) 269-6538

906 Park Ave
Orange Park, FL 32073
Phone (904) 541-0315

Interoperability endpoints

  • Direct secure messaging: isosa@townederm.emadirect.md

Organizations & group practices 4

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1225287576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18228 N US HIGHWAY 41",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335494400",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 S PONCE DE LEON BLVD STE 3B",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320846013",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 3rd St S",
            "address_purpose": "LOCATION",
            "city": "Jacksonville Beach",
            "state": "FL",
            "postal_code": "322506096",
            "country_code": "US",
            "telephone_number": "813-321-1786",
            "fax_number": "813-321-1787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "URB INDUSTRIAL REPARADA 2 396 DR LUIS F SALA",
            "address_purpose": "LOCATION",
            "city": "PONCE",
            "state": "PR",
            "postal_code": "007167004",
            "country_code": "US",
            "telephone_number": "787-840-2317 x5835",
            "fax_number": "787-840-2317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOSA SEDA",
        "first_name": "IVETTE",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-11",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "PR",
            "license": "17959",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "FL",
            "license": "ME133840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IVETTE",
            "last_name": "SOSA-SEDA",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in St Augustine, FL

Sources for this page

Verify at the official NPI Registry.