Mary Annette Seagraves, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

DR.0028267 Issued in CO

Practice address

4110 Briargate Pkwy Ste 140
Colorado Springs, CO 80920-7836

Phone

(719) 364-8346

Fax

(719) 364-6488

NPI assigned

Dec 30, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Locations

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

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868

  Surgery

  Medicare reassignment NPD
• Rocky Mountain Vein Institute Professional LLC

  • Vascular & Interventional Radiology Physician
  • Pueblo, CO
  • NPI 1457685398
  Medicare reassignment NPD
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Rocky Mountain Vein Institute, PLLC

  • Vascular & Interventional Radiology Physician
  • Colorado Springs, CO
  • NPI 1457942898
  NPD
• Cardiodiagnostics of Colorado Springs, Inc.

  • Physiological Laboratory
  • Colorado Springs, CO
  • NPI 1750486924
  NPD (past)
• Memorial Health System

  • General Acute Care Hospital
  • Colorado Springs, CO
  • NPI 1568668754

  Surgery

  NPD (past)

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698192000000",
    "number": "1770560617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8890 N UNION BLVD",
            "address_2": "STE 160",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207799",
            "telephone_number": "719-365-9950",
            "fax_number": "719-365-9969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 BRIARGATE PKWY STE 140",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809207836",
            "telephone_number": "719-364-8346",
            "fax_number": "719-364-6488"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "175 S Union Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809103117",
            "country_code": "US",
            "telephone_number": "719-372-5555",
            "fax_number": "719-545-1829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEAGRAVES",
        "first_name": "MARY",
        "middle_name": "ANNETTE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-30",
        "last_updated": "2023-10-25",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "",
            "desc": "Phlebology",
            "state": "CO",
            "license": "DR.0028267",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CO",
            "license": "DR.0028267",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01282672",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timothy Lee Scudder, LPC
• Derek Scullin
• Anthony Scully
• Kari Scyoc-Wilson, MS, LPC
• Kathleen Seabron
• Kristen Seagren, LCSW
• Alexandra Sealey
• Frank Eugene Seaman, DDS, MS
• Rebecca S Seamster-Davis, RN
• Sean C Odonnell

• Surgery Physician in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Surgery Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2023; 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.