Sarah Mardanlou, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

27706 Issued in WV

Practice address

610 Kitty Hawk St
Van Buren, AR 72956-2132

Phone

(479) 719-0562

NPI assigned

Apr 8, 2015

Last updated

Mar 11, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Crouse Health Hospital, Inc.

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1033107743
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552262400000",
    "number": "1144616020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 KITTY HAWK ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562132",
            "telephone_number": "479-719-0562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 KITTY HAWK ST",
            "city": "VAN BUREN",
            "state": "AR",
            "postal_code": "729562132",
            "telephone_number": "479-719-0562"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6040 University Town Centre Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265012421",
            "country_code": "US",
            "telephone_number": "304-598-4835",
            "fax_number": "304-285-7388",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARDANLOU",
        "first_name": "SARAH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-08",
        "last_updated": "2019-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "27706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Mainer, LMSW
• Manes Pharmacy, Inc (Super Sav Drug #3)
• Lisa M Manes-Mankins, M.S., CCC-SLP
• Raelene A Mapes, DO
• Amity Sparks Marcial, DPT
• Natalie Marine
• Marquis Therapy Services Inc.
• Patricia Ann Marquis, OTR/L
• Alexandria Marrone, MS
• Manuel Marroquin

• Pediatrics Physician in Van Buren, AR
• Providers in Van Buren, AR by specialty
• Pediatrics Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.