NPIMap

Individual provider Active NPI

Michael A Saridakis, MD

  • Surgery Physician
  • Glasgow, KY
National Provider Identifier
1407850134
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
48331 Issued in KY
Practice address
310 N L Rogers Wells Blvd Ste 103
Glasgow, KY 42141-1300
Phone
(270) 659-5945
Fax
(270) 659-5855
NPI assigned
Jun 10, 2005
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 29430 TN
Surgery Physician 208600000X 48331 KY Primary

Addresses

Primary practice location

310 N L Rogers Wells Blvd Ste 103
Glasgow, KY 42141-1300

Mailing address

310 N L Rogers Wells Blvd
Glasgow, KY 42141-1300
Phone (270) 659-5945

Other identifiers 3

IdentifierTypeStateIssuer
7100356140MedicaidKY
3814598MedicaidTN
K130430OtherKYMEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address msaridakis@tjrh.cernerdirect.com T J Samson Community Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040130000395 TN Practitioner - General Surgery 6406759083
I20150526001217 KY Practitioner - General Surgery 6406759083 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
T J Samson Community HospitalGroup PAC ID 0648182600, 197 clinicians

Practice addresses (Care Compare)

1301 N Race St
Glasgow, KY 42141-3454
Phone (270) 651-4444

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.3 of 100Reported as group
Quality
74.59
Promoting interoperability
100
Improvement activities
40
Cost
68.87

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy29
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux11
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
29430TNMDPharmacist
48331KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
T J Samson Community Hospital CurrentSince Jun 8, 2015 Accepting new patients
T J Samson Community Hospital Current Accepting new patients
T J Samson Community Hospital Current Accepting new patients
Decatur County General Hospital Past Accepting new patients
T J Samson Community Hospital Past Accepting new patients

Locations

1301 N Race St
Glasgow, KY 42141
Phone (270) 651-4141

310 N L Rogers Wells Blvd
Glasgow, KY 42141
Phone (270) 651-1111

310 N L Rogers Wells Blvd
Ste 103
Glasgow, KY 42141
Phone (270) 659-5945

Interoperability endpoints

  • Direct secure messaging: msaridakis@tjrh.cernerdirect.com

Ownership & related parties

All facility ownership & control disclosures 13

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
T J Samson Community HospitalGlasgow, KY, CCN 180017 Hospital Corporate Director Mar 20, 2021
T J Health ColumbiaColumbia, KY, CCN 180149 Hospital Corporate Director Jan 1, 2021
T J Health ColumbiaColumbia, KY, CCN 18U149 Hospital Corporate Director Jan 1, 2022
T J Samson Home HealthGlasgow, KY, CCN 187062 Home health agency Corporate Director Jan 1, 2022
T J Samson HospiceGlasgow, KY, CCN 181531 Hospice Corporate Director Jan 1, 2021
T J Health Columbia Primary CareColumbia, KY, CCN 183998 Rural health clinic Corporate Director Jan 1, 2022
T J Health Russell SpringsRussell Springs, KY, CCN 183446 Rural health clinic Corporate Director Jan 1, 2022
T J Health EdmontonEdmonton, KY, CCN 183994 Rural health clinic Corporate Director Jan 1, 2022
T J Health Columbia ClinicColumbia, KY, CCN 183970 Rural health clinic Corporate Director Jan 1, 2022
T J Health Cave CityCave City, KY, CCN 183493 Rural health clinic Corporate Director Jan 1, 2022
T J Health Greensburg ClinicGreensburg, KY, CCN 183496 Rural health clinic Corporate Director Jan 1, 2022
T J Health Tompkinsville ClinicTompkinsville, KY, CCN 188500 Rural health clinic Corporate Director Jan 1, 2022
T J Health ScottsvilleScottsville, KY, CCN 188527 Rural health clinic Corporate Director Jan 1, 2022

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1407850134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 N L ROGERS WELLS BLVD",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411300",
            "telephone_number": "270-659-5945",
            "fax_number": "270-659-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 N L ROGERS WELLS BLVD STE 103",
            "city": "GLASGOW",
            "state": "KY",
            "postal_code": "421411300",
            "telephone_number": "270-659-5945",
            "fax_number": "270-659-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARIDAKIS",
        "first_name": "MICHAEL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "29430",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "48331",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100356140",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3814598",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "K130430",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "msaridakis@tjrh.cernerdirect.com",
            "affiliation": "Y",
            "affiliationName": "T J Samson Community Hospital",
            "address_1": "310 N L Rogers Wells Blvd Ste 103",
            "city": "Glasgow",
            "state": "KY",
            "country_code": "US",
            "postal_code": "421411300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glasgow, KY

Sources for this page

Verify at the official NPI Registry.