DR. SEAN MICHAEL DOWNES M.D.
NPI 1225395452
Family Medicine in Cleveland, OH

Q: What is Sean Downes's NPI number?

The NPI number for Sean Downes is 1225395452. It was assigned to this individual provider in the NPPES registry on April 12, 2012.

Q: What is Sean Downes's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Sean Downes was last updated on December 27, 2021. 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.

Active since April 12, 2012PECOS EnrolledAccepts Medicare Assignment

2500 METROHEALTH DR, CLEVELAND, OH 44109(216) 778-7800 Get Directions Write a Review

NPPES record last updated: December 27, 2021. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Dr. Sean Michael Downes M.d. NPPES

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

DR. SEAN MICHAEL DOWNES M.D. (NPI 1225395452) is an individual family medicine provider in Cleveland, Ohio, licensed in Ohio (35.124553) and active in the NPI registry since April 2012. He is enrolled in Medicare PECOS, is affiliated with Metrohealth System, and is a graduate of Other (2009).

NPPES Registry Identity

NPI1225395452

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameDR. SEAN MICHAEL DOWNESCredential: M.D.

Location Address2500 METROHEALTH DRCleveland, OH 44109-1900

Mailing Address2500 Metrohealth DrCleveland, OH 44109-1900 · (216) 778-7800

Phone(216) 778-7800

Sole ProprietorNo

Medical School CMSOtherGraduated 2009

Enumeration DateApril 12, 2012

Last NPPES UpdateDecember 27, 2021

✔ NPI 1225395452 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in OH · 35.124553

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2500 METROHEALTH DR, Cleveland, OH 44109

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual 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

Dr. Sean Michael Downes 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 ID4284876848

PECOS Enrollment IDI20150702001374

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 3

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.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

198 services190 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

59 services58 patients

Initial hospital care with same-day admission and discharge with high level of medical decision making, per day, if using time, at least 85 minutes 99236

This service involves a brief hospital stay for a serious health issue. Patients are admitted and discharged on the same day, typically within 55 minutes. It allows for close monitoring and immediate treatment, ensuring optimal care.

20 services20 patients

Hospital Affiliations CMS Care Compare 5

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

Metrohealth System

Acute Care Hospitals · Cleveland, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360059

Location2500 Metrohealth DriveCleveland, OH 44109 · Cuyahoga County

Emergency services Birthing friendly

Mercy Medical Center

Acute Care Hospitals · Canton, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360070

Location1320 Mercy Drive NWCanton, OH 44708 · Stark County

Emergency services Birthing friendly

Aultman Hospital

Acute Care Hospitals · Canton, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360084

Location2600 Sixth Street SWCanton, OH 44710 · Stark County

Emergency services Birthing friendly

Alliance Community Hospital

Acute Care Hospitals · Alliance, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360131

Location200 East State StreetAlliance, OH 44601 · Stark County

Emergency services

Aultman Orrville Hospital

Critical Access Hospitals · Orrville, OH

OwnershipVoluntary non-profit - Private

CMS Certification Number361323

Location832 South Main StreetOrrville, OH 44667 · Wayne County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 44109 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.10 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

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.

AMIR RAZAVI MD

Internal Medicine