Individual provider Active NPI

Sean Alexander Castellucci, D.O.

  • Urology Physician
  • Bradenton, FL
National Provider Identifier
1487869400
Registry record updated Apr 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
OS11276 Issued in FL
Practice address
200 3Rd Ave W
Suite 210
Bradenton, FL 34205-8626
Phone
(941) 792-0340
Fax
(941) 794-2251
NPI assigned
May 12, 2007
Last updated
Apr 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X OS013044 PA
Urology Physician 208800000X OS11276 FL Primary

Addresses

Primary practice location

200 3Rd Ave W
Suite 210
Bradenton, FL 34205-8626

Mailing address

2234 Colonial Blvd
Attn: Payer Contracting & Relations
Fort Myers, FL 33907-1412
Phone (239) 931-7342

Other identifiers 9

IdentifierTypeStateIssuer
14EH4OtherFLBCBS FL
236008OtherFLUNVERSAL HEALTHCARE
P939461OtherFLOPTIMUM
P01800301OtherFLCLEAR HEALTH
P993826OtherFLFREEDOM HEALTH
529659OtherFLWELLCARE
P01042688OtherFLRAILROAD MCR
353765OtherFLAVMED
9213454OtherFLAETNA

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
I20110829000431 FL Practitioner - Urology 6204981764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Precision Healthcare Specialists, LLCGroup PAC ID 6103284955, 129 clinicians

Practice addresses (Care Compare)

200 3Rd Ave W
Suite 210
Bradenton, FL 34205-8633
Phone (941) 792-0340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection48

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS013044PAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Genesiscare USA of Florida LLC Urology Current Accepting new patients
Precision Healthcare Specialists, LLC Urology CurrentSince Sep 1, 2024 Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Mar 31, 2012 Accepting new patients
Genesiscare USA of Florida LLC Urology CurrentSince Mar 31, 2012 Accepting new patients
Genesiscare USA of Florida LLC Urology Past Accepting new patients
Up Anesthesia Services LLC PastSince Oct 1, 2018 Accepting new patients
Rice and Lake Urology LLP Urology Past Accepting new patients

Locations

200 3rd Ave W
Ste 210
Bradenton, FL 34205
Phone (941) 782-5439

13691 Metro Pkwy
Ste 300
Fort Myers, FL 33912
Phone (239) 291-6970

2234 Colonial Blvd
Fort Myers, FL 33907
Phone (239) 931-7212

8946 77th Ter E
Lakewood Ranch, FL 34202
Phone (941) 792-0340

730 Goodlette Rd
Ste 201
Naples, FL 34102
Phone (239) 262-1119

1685 Tamiami Trl
Bldg 4
Pt Charlotte, FL 33948
Phone (239) 374-5220

1 S School Ave
Ste 200
Sarasota, FL 34237

842 Sunset Lake Blvd
Ste 403
Venice, FL 34292
Phone (941) 485-3351

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: scastellucci@phs.emadirect.md

Organizations & group practices 7

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 6

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": "1178928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491955200000",
    "number": "1487869400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 3RD AVE W",
            "address_2": "SUITE 210",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342058626",
            "telephone_number": "941-792-0340",
            "fax_number": "941-794-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTELLUCCI",
        "first_name": "SEAN",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-12",
        "last_updated": "2017-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "PA",
            "license": "OS013044",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "FL",
            "license": "OS11276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "14EH4",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNVERSAL HEALTHCARE",
            "identifier": "236008",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMUM",
            "identifier": "P939461",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLEAR HEALTH",
            "identifier": "P01800301",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FREEDOM HEALTH",
            "identifier": "P993826",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "529659",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01042688",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "353765",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9213454",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.