Individual provider Active NPI

Sean Emmanuel Maldonado Ramirez, M.D.

  • Body Imaging Physician
  • Jacksonville, FL
National Provider Identifier
1770984627
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
ME150799 Issued in FL
Practice address
14550 Old Saint Augustine Rd
Jacksonville, FL 32258-2460
Phone
(312) 724-8477
NPI assigned
Sep 10, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X A145291 CA
Body Imaging Physician 2085B0100X ME150799 FL Primary

Addresses

Primary practice location

14550 Old Saint Augustine Rd
Jacksonville, FL 32258-2460

Mailing address

PO Box 31309
Los Angeles, CA 90031-0309
Phone (323) 442-8541

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sean.maldonadoramirez@direct.usc.edu Direct USC CARE MEDICAL GROUP, INC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20200512002975 CA Practitioner - Diagnostic Radiology 8921439662 Reassigns benefits to 1 organization
I20210812003619 FL Practitioner - Diagnostic Radiology 8921439662 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mori Bean and Brooks IncGroup PAC ID 8820077878, 966 clinicians

Practice addresses (Care Compare)

1524 SW 28TH St
Fort Lauderdale, FL 33315-2750
Phone (904) 399-5550

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A145291CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Usc Care Medical Group, Inc Diagnostic Radiology CurrentSince Jun 1, 2020 Accepting new patients
Northside Radiology Associates LLC Diagnostic Radiology CurrentSince Dec 16, 2024 Accepting new patients
Usc Care Medical Group, Inc CurrentSince Jun 1, 2020 Accepting new patients
Mori Bean and Brooks Inc Body Imaging CurrentSince Mar 4, 2024 Accepting new patients
Mountain Radiology, Inc Diagnostic Radiology Past Accepting new patients

Locations

420 34th St
Bakersfield, CA 93301
Phone (661) 324-4647

1520 San Pablo St
Los Angeles, CA 90033
Phone (323) 442-5849

1500 San Pablo St
Fl 2
Los Angeles, CA 90033
Phone (323) 442-8541

14550 Old St Augustine Rd
Jacksonville, FL 32258
Phone (904) 202-5010

2001 Kingsley Ave
Orange Park, FL 32073
Phone (904) 215-7015

13695 US Highway 1
Sebastian, FL 32958
Phone (772) 589-3185

2115 Little Rd
Trinity, FL 34655
Phone 7278418225410

1000 Johnson Ferry Rd
Sandy Springs, GA 30342
Phone (404) 851-8737

Interoperability endpoints

  • Direct secure messaging: smaldonadoramirez2022706@direct.trinity-health.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1410307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1770984627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 31309",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900310309",
            "telephone_number": "323-442-8541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14550 OLD SAINT AUGUSTINE RD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322582460",
            "telephone_number": "312-724-8477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO RAMIREZ",
        "first_name": "SEAN",
        "middle_name": "EMMANUEL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-10",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A145291",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "FL",
            "license": "ME150799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sean.maldonadoramirez@direct.usc.edu",
            "affiliation": "Y",
            "affiliationName": "USC CARE MEDICAL GROUP, INC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1500 San Pablo St Fl 2",
            "city": "Los Angeles",
            "state": "CA",
            "country_code": "US",
            "postal_code": "900335313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.