DR. SEAN MICHAEL DOWNES M.D.
NPI 1225395452
Family Medicine in Cleveland, OH
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
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.
Medicare Billing Reassignments
8Medicare enrollment records show Sean Downes reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Cleveland, OH 44109
- Reassigned Medicare billing, Ohio enrollment
- 2,147 clinicians in this Medicare group
Hudson, OH 44236
- Reassigned Medicare billing, Ohio enrollment
- 215 clinicians in this Medicare group
Akron, OH 44304
- Reassigned Medicare billing, Ohio enrollment
- 259 clinicians in this Medicare group
North Canton, OH 44720
- Reassigned Medicare billing, Ohio enrollment
- 71 clinicians in this Medicare group
Orrville, OH 44667
- Reassigned Medicare billing, Ohio enrollment
- 124 clinicians in this Medicare group
Canton, OH 44708
- Reassigned Medicare billing, Ohio enrollment
- 456 clinicians in this Medicare group
Canton, OH 44710
- Reassigned Medicare billing, Ohio enrollment
- 189 clinicians in this Medicare group
Columbus, OH 43213
- Reassigned Medicare billing, Ohio enrollment
- 776 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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, OHAultman Hospital
Acute Care Hospitals · Canton, OHAlliance Community Hospital
Acute Care Hospitals · Alliance, OHTwin City Medical Center
Critical Access Hospitals · Dennison, OHAultman Orrville Hospital
Critical Access Hospitals · Orrville, OHPhysician 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.
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.
CLEVELAND, OH 44109
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 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.
Where is Sean Downes located?
Sean Downes practices at 2500 Metrohealth Dr, Cleveland, OH 44109. The listed phone number is (216) 778-7800.
What is Sean Downes's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sean Downes enrolled in Medicare?
Yes. Sean Downes 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.
Which organizations bill Medicare for Sean Downes's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Sean Downes reassigns Medicare benefits to 8 organizations: The Metrohealth System (Cleveland, OH), Inpatient Medical Services, Inc. (Hudson, OH), 4M Hospitalist Services, LLC (Akron, OH), Aultman Now Urgent Care, LLC (North Canton, OH), Orrville Hospital Foundation (Orrville, OH) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sean Downes's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Sean Downes accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource and 3 other insurers list Sean Downes 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 Sean Downes affiliated with any hospitals?
According to CMS data, Sean Downes is affiliated with Metrohealth System, Aultman Hospital, Alliance Community Hospital, Twin City Medical Center and Aultman Orrville Hospital.
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.
# Dr. Sean Michael Downes, M.D. · NPI 1225395452
Family Medicine physician in Cleveland, Ohio. Individual provider, active in the CMS NPPES registry since April 12, 2012.
## Identity
- **NPI:** 1225395452 (Entity type: Individual)
- **Enumerated:** April 12, 2012
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **State license:** 35.124553 (Ohio)
- **Sole proprietor:** No
## Practice location
- **Address:** 2500 METROHEALTH DR, Cleveland, OH 44109-1900
- **Phone:** (216) 778-7800
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): The Metrohealth System (NPI 1053353896, Cleveland, OH); Inpatient Medical Services, Inc. (NPI 1093756314, Hudson, OH); 4M Hospitalist Services, LLC (NPI 1508288531, Akron, OH); Aultman Now Urgent Care, LLC (NPI 1225662927, North Canton, OH); Orrville Hospital Foundation (NPI 1891718375, Orrville, OH); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2009
## Record status
- **NPPES last updated:** December 27, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1225395452) · Data from the CMS NPPES public registry.