DR. CARLOS ANTONIO SESIN M.D.
NPI 1659304707
Internal Medicine - Rheumatology in Miami Beach, FL

Q: What is Carlos Sesin's NPI number?

The NPI number for Carlos Sesin is 1659304707. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Q: What is Carlos Sesin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Q: When was this NPI record last updated?

The NPPES record for Carlos Sesin was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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 July 09, 2006PECOS EnrolledAccepts Medicare Assignment

75/100

CMS Quality Rating

4302 ALTON RD, SUITE 550, MIAMI BEACH, FL 33140(305) 531-6766(305) 531-6712 Get Directions Write a Review

NPPES record last updated: August 31, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Carlos Antonio Sesin M.d. NPPES

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

DR. CARLOS ANTONIO SESIN M.D. (NPI 1659304707) is an individual rheumatology provider in Miami Beach, Florida, licensed in Florida (ME89368) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Mount Sinai Medical Center Of Florida, Inc, and maintains a secondary practice location in Coral Gables.

NPPES Registry Identity

NPI1659304707

Entity TypeIndividualMale

Primary Taxonomy207RR0500X

Provider Legal NameDR. CARLOS ANTONIO SESINCredential: M.D.

Location Address4302 ALTON RD, SUITE 550Miami Beach, FL 33140-2891

Mailing Address1801 Ponce De Leon BlvdCoral Gables, FL 33134-4418 · (305) 531-6766 · Fax (305) 531-6712

Phone(305) 531-6766

Fax(305) 531-6712

Sole ProprietorYes

Medical School CMSRutgers R W Johnson Medical School (cam/new Bruns/pisc)Graduated 1999

Enumeration DateJuly 9, 2006

Last NPPES UpdateAugust 31, 2021

NPPES CertifiedAugust 31, 2021

✔ NPI 1659304707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · RheumatologyAllopathic & Osteopathic Physicians

Taxonomy Code207RR0500X

License✔ Licensed in FL · ME89368

Definition

An internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and collagen diseases.

4302 ALTON RD, Miami Beach, FL 33140

Open in Google Maps ↗

Secondary Practice Location 1

Location 11801 Ponce De Leon BlvdCoral Gables, FL 33134-4418 · Phone (305) 531-6766 · Fax (305) 531-6712

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare, Cigna HealthCare of Florida, Inc., Florida Blue (BlueCross BlueShield FL) and more.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. Carlos Antonio Sesin 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 ID9739167891

PECOS Enrollment IDI20040714000575

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.

Medicare Billing Reassignment

Medicare enrollment records show Carlos Sesin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Carlos A. Sesin, MD, PA

Same address

Rheumatology

4302 ALTON RD, SUITE 550
Miami Beach, FL 33140

Reassigned Medicare billing, Florida enrollment
5 clinicians in this Medicare group

NPI 1639364144 (305) 531-6766

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 14

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.

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

24,120 services237 patients

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.

920 services538 patients

Administration of non-hormonal anti-neoplastic chemotherapy under skin or into muscle 96401

This procedure involves giving anti-cancer drugs, which don't contain hormones, into the muscle or under the skin. These drugs help to stop the growth of cancer cells. The process is usually quick and done by a healthcare professional.

778 services274 patients

Injection, zoledronic acid, 1 mg J3489

Zoledronic acid is a medication given via injection to strengthen bones. It's often used in patients with osteoporosis or certain types of cancer. The injection helps reduce the risk of fractures and other bone complications.

280 services56 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

170 services72 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

151 services106 patients

Hyaluronan or derivative, monovisc, for intra-articular injection, per dose J7327

Monovisc is a treatment involving an injection of hyaluronan or its derivative into a joint, often the knee. This substance, found naturally in joint fluid, helps lubricate and cushion the joint. The injection can help ease pain, improve mobility, and reduce inflammation caused by arthritis.

131 services55 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.

103 services103 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

102 services24 patients

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

79 services61 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

58 services58 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

20 services17 patients

Injection, methylprednisolone acetate, 40 mg J1030

Methylprednisolone acetate is a medication given through an injection. It's a type of corticosteroid, which reduces inflammation and immune responses. It can be used to treat various conditions like arthritis, allergies, and skin diseases. This dose is 40 mg.

19 services17 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

13 services13 patients

Hospital Affiliations CMS Care Compare 3

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

Mount Sinai Medical Center Of Florida, Inc

Acute Care Hospitals · Miami Beach, FL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100034

Location4300 Alton RdMiami Beach, FL 33140 · Miami-Dade County

Emergency services Birthing friendly

South Miami Hospital

Acute Care Hospitals · South Miami, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100154

Location6200 SW 73rd StSouth Miami, FL 33143 · Miami-Dade County

Emergency services Birthing friendly

Doctors Hospital

Acute Care Hospitals · Coral Gables, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number100296

Location5000 University DrCoral Gables, FL 33146 · Miami-Dade County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33140 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

$141.56 typical visit price

range $60.92 – $187.05

Typical copayment $35.39 (range $15.23 – $46.76)

Most-billed visit code 99204

Established Patient

$107.17 typical visit price

range $18.99 – $150.24

Typical copayment $26.79 (range $4.74 – $37.56)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

75/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Reported Quality Measures

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

79%1,028 patients4/55-star benchmark: 100%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

94%3,170 patients4/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

99%2,348 patients4/55-star benchmark: 100%

Patient-Specific Education

The MIPS eligible clinician must use clinically relevant information from certified EHR technology to identify patient-specific educational resources and provide electronic access to those materials to at least one unique patient seen by the MIPS eligible…

68%1,871 patients3/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…

100%647 patients5/55-star benchmark: 100%

Provide Patient Access

For at least one unique patient seen by the MIPS eligible clinician: (1) The patient (or the patient authorized representative) is provided timely access to view online, download, and transmit his or her health information; and (2) The MIPS eligible clinician…

61%1,871 patients3/55-star benchmark: 100%

Rheumatoid Arthritis (RA): Glucocorticoid Management

Percentage of patients aged 18 years and older with a diagnosis of rheumatoid arthritis (RA) who have been assessed for glucocorticoid use and, for those on prolonged doses of prednisone >= 10 mg daily (or equivalent) with improvement or no change in disease…

56%228 patients3/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

Percentage of female patients aged 65-85 years of age who ever had a central dual-energy X-ray absorptiometry (DXA) to check for osteoporosis

61%548 patients3/55-star benchmark: 97%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

1 supplier11 claims11 services$46.71 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

OUELLETTE GROUP PHYSICIANS FOR THE HAND

Orthopaedic Surgery (Hand Surgery)

4302 ALTON RD, SUITE 710
MIAMI BEACH, FL 33140

Miami-Dade County (786) 261-0222

DAVID COHN MD PA

Internal Medicine

4302 ALTON RD, SUITE 300
MIAMI BEACH, FL 33140

Miami-Dade County (305) 531-6600

DR. JOSE R TOLEDO M.D.

Physical Medicine & Rehabilitation

4302 ALTON RD, SUITE 420
MIAMI BEACH, FL 33140

Miami-Dade County (305) 672-1256

INIEDDY RODRIGUEZ BORNOT

Nurse Practitioner (Acute Care)

4302 ALTON RD
MIAMI BEACH, FL 33140

Miami-Dade County (786) 584-5560

DR. DAVID L LIPKIN M.D.

Physical Medicine & Rehabilitation

4302 ALTON RD, SUITE 420
MIAMI BEACH, FL 33140

Miami-Dade County (305) 672-1256

COMPREHENSIVE PRIMARY CARE

Internal Medicine

4302 ALTON RD, SUITE 900
MIAMI BEACH, FL 33140

Miami-Dade County (305) 534-4888

MEDICAL CENTER OF WINSTON TOWERS INC

Internal Medicine

4302 ALTON RD, SUITE 320
MIAMI BEACH, FL 33140

Miami-Dade County (305) 538-7344

IRVING JORGE MD

Surgery

4302 ALTON RD, SUITE 540
MIAMI BEACH, FL 33140

Miami-Dade County (305) 674-2151

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 Carlos Sesin's NPI number?

The NPI number for Carlos Sesin is 1659304707. It was assigned to this individual provider in the NPPES registry on July 9, 2006.

Where is Carlos Sesin located?

Carlos Sesin practices at 4302 Alton Rd Suite 550, Miami Beach, FL 33140. The listed phone number is (305) 531-6766.

What is Carlos Sesin's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Rheumatology, with taxonomy code 207RR0500X.

Is Carlos Sesin enrolled in Medicare?

Yes. Carlos Sesin 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 organization bills Medicare for Carlos Sesin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Carlos Sesin reassigns Medicare benefits to Carlos A. Sesin, MD, PA (Miami Beach, FL). The 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 Carlos Sesin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Carlos Sesin accept?

Health plans from Cigna HealthCare of Florida, Inc., Cigna Healthcare, Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Carlos Sesin 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 Carlos Sesin affiliated with any hospitals?

According to CMS data, Carlos Sesin is affiliated with Mount Sinai Medical Center Of Florida, Inc, South Miami Hospital and Doctors Hospital.

When was this NPI record last updated?

The NPPES record for Carlos Sesin was last updated on August 31, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.