Individual provider Active NPI

Sarath K Palakodeti, DO

  • Surgery Physician
  • Bowling Green, KY
National Provider Identifier
1639331887
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
TP286 Issued in KY
Practice address
484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914
Phone
(270) 780-0579
Fax
(270) 936-6029
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X TP286 KY Primary
Surgery Physician 208600000X 34.010446 OH
Surgery Physician 208600000X 70564 GA

Addresses

Primary practice location

484 Golden Autumn Way Ste 201
Bowling Green, KY 42103-6914

Mailing address

201 Park St
Bowling Green, KY 42101-1742
Phone (270) 781-5111

Other identifiers 1

IdentifierTypeStateIssuer
0151389MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, KY2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20151208000718 OH Practitioner - General SurgeryPractitioner - Plastic and Reconstructive Surgery 7012137078 Reassigns benefits to 4 organizations
I20250502001530 KY Practitioner - General Surgery 7012137078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Lake Erie College of Osteopathic Medicine, Erie, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Graves Gilbert Clinic PLLCGroup PAC ID 4082511167, 207 clinicians

Practice addresses (Care Compare)

484 Golden Autumn Way
Suite 201
Bowling Green, KY 42103-6914
Phone (270) 781-5111

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70564GAMDSurgery Physician
TP286KYMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Gilbert Clinic PLLC CurrentSince Jun 2, 2025 Accepting new patients
Graves Gilbert Clinic PLLC CurrentSince Jun 2, 2025 Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

484 Golden Autumn Way
Ste 201
Bowling Green, KY 42103
Phone (270) 783-3300

201 Park St
Bowling Green, KY 42101
Phone (270) 651-2229

Interoperability endpoints

  • Direct secure messaging: sarath.palakodeti.p1@direct.whc.nextgenshare.com
  • Direct secure messaging: sarathpalakodeti@ggc.allscriptsdirect.net

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749081600000",
    "number": "1639331887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 PARK ST",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421011742",
            "telephone_number": "270-781-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "484 GOLDEN AUTUMN WAY STE 201",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421036914",
            "telephone_number": "270-780-0579",
            "fax_number": "270-936-6029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALAKODETI",
        "first_name": "SARATH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "KY",
            "license": "TP286",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "34.010446",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "70564",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0151389",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

Verify at the official NPI Registry.