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RAMIRO SERGIO MALDONADO M.D.
NPI 1215228036
Ophthalmology in Durham, NC

Active since April 27, 2011PECOS EnrolledAccepts Medicare Assignment
DUKE UNIVERSITY MEDICAL CTR, OPHTHALMOLOGY DEPARTMENT, DURHAM, NC 27710(919) 681-3816(919) 681-8856 Get Directions Write a Review

NPPES record last updated: April 6, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 6, 2022, Jun 29, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2018).

About Ramiro Sergio Maldonado M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RAMIRO SERGIO MALDONADO M.D. (NPI 1215228036) is an individual ophthalmology provider in Durham, North Carolina, licensed in North Carolina (2022-00189) and active in the NPI registry since April 2011. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and is a graduate of Other (2002).

NPPES Registry Identity

NPI1215228036
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameRAMIRO SERGIO MALDONADOCredential: M.D.
Location AddressDUKE UNIVERSITY MEDICAL CTR, OPHTHALMOLOGY DEPARTMENTDurham, NC 27710-0001
Mailing Address5213 S Alston AveDurham, NC 27713-4430 · (919) 620-4855
Phone(919) 681-3816
Fax(919) 681-8856
Sole ProprietorNo
Medical School CMSOtherGraduated 2002
Enumeration DateApril 27, 2011
Last NPPES UpdateApril 6, 20224 updates tracked since enumeration
NPPES CertifiedApril 6, 2022
✔ NPI 1215228036 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in NC · 2022-00189✔ Licensed in PA · MD457242
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedOphthalmology · Retina SpecialistTaxonomy 207WX0107X · License 51521 (KY)
DUKE UNIVERSITY MEDICAL CTR, Durham, NC 27710
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ramiro Sergio Maldonado M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173872454
PECOS Enrollment IDI20220414001881
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 11

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
213 services153 patients
Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
203 services161 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
192 services85 patients
Injection of drug into eye 67028
An injection into the eye is a procedure where a medication is delivered directly into your eye to treat various conditions. A local anesthetic is applied to numb the eye, ensuring minimal discomfort. The drug helps manage diseases like macular degeneration or diabetic retinopathy.
154 services35 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
42 services42 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
39 services39 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Duke University Hospital

Acute Care Hospitals · Durham, NC
5/5 CMS rating
OwnershipProprietary
CMS Certification Number340030
Location2100 Erwin RdDurham, NC 27705 · Durham County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27710 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$125.01 typical visit price
range $54.12 – $165.09
Typical copayment $31.25 (range $13.53 – $41.27)
Most-billed visit code 99204
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MEGAN MCVAY PHD
Psychologist (Clinical)
DUKE UNIVERSITY MEDICAL CTR, DEPARTMENT OF PSYCHIATRY
DURHAM, NC 27710
Durham County (919) 668-7216
MICHELLE BAILEY M.D.
Pediatrics
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (919) 620-4467
JEFFREY CRAWFORD M.D.
Internal Medicine (Hematology & Oncology)
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (919) 620-4467
CHARLES GERARDO M.D.
Emergency Medicine
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (919) 620-4467
KALEY TASH
Internal Medicine
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (727) 510-0883
REID CAMERON CHAMBERLAIN M.D.
Pediatrics (Pediatric Cardiology)
DUKE UNIVERSITY MEDICAL CTR, BOX 3951
DURHAM, NC 27710
Durham County (919) 684-3491
MEGAN CLOWSE
Internal Medicine (Rheumatology)
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (919) 620-4467
NICOLE CALAKOS M.D., PH.D
Neurological Surgery
DUKE UNIVERSITY MEDICAL CTR
DURHAM, NC 27710
Durham County (919) 620-4467

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ramiro Maldonado's NPI number?

The NPI number for Ramiro Maldonado is 1215228036. It was assigned to this individual provider in the NPPES registry on April 27, 2011.

Where is Ramiro Maldonado located?

Ramiro Maldonado practices at Duke University Medical Ctr Ophthalmology Department, Durham, NC 27710. The listed phone number is (919) 681-3816.

What is Ramiro Maldonado's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Ramiro Maldonado enrolled in Medicare?

Yes. Ramiro Maldonado is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ramiro Maldonado accept?

Health plans from Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and Blue Cross and Blue Shield of NC list Ramiro Maldonado as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Ramiro Maldonado affiliated with any hospitals?

According to CMS data, Ramiro Maldonado is affiliated with Duke University Hospital.

When was this NPI record last updated?

The NPPES record for Ramiro Maldonado was last updated on April 6, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.