Sean Carter Mardis, DO

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0102206098 Issued in VA

Practice address

1900 Grant St Suite 600
Denver, CO 80203

Phone

(970) 310-3406

Fax

(888) 965-4615

NPI assigned

May 7, 2018

Sex

Male

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 VA

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 Osteopathy

State licenses

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1417446246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRANT ST SUITE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80203",
            "telephone_number": "970-310-3406",
            "fax_number": "888-965-4615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GRANT ST SUITE 600",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80203",
            "telephone_number": "970-310-3406",
            "fax_number": "888-965-4615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARDIS",
        "first_name": "SEAN",
        "middle_name": "CARTER",
        "name_prefix": "Mr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CO",
            "license": "DR.0068431",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102206098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elodie (Dee) Marcotte, M.S., M.A
• Hayley Marcus, MD
• Sharon Marcus, CMT
• Abby J Marder, LSW
• Brad A Marder, MD
• Mabel A Mardones, M.D.
• Michael Mare
• Lisa M Mareb, LCSW
• Kristin Maresca
• Ravi S Marfatia, MD

• Psychiatry Physician in Denver, CO
• Providers in Denver, CO by specialty
• Psychiatry Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.