PRAKASH PANDALAI MD
NPI 1275735789
Surgery - Surgical Oncology in Lexington, KY

Q: What is Prakash Pandalai's NPI number?

The NPI number for Prakash Pandalai is 1275735789. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Q: What is Prakash Pandalai's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Oncology, with taxonomy code 2086X0206X.

Q: When was this NPI record last updated?

The NPPES record for Prakash Pandalai was last updated on May 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 05, 2007PECOS EnrolledAccepts Medicare Assignment

100/100

CMS Quality Rating

800 ROSE ST, 1ST FL, LEXINGTON, KY 40536(859) 323-6542(859) 323-2074 Get Directions Write a Review

NPPES record last updated: May 5, 2021. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: May 5, 2021, Jul 9, 2019, Feb 3, 2017 (3 updates tracked since 2017).

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About Prakash Pandalai Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRAKASH PANDALAI MD (NPI 1275735789) is an individual surgical oncology provider in Lexington, Kentucky, licensed in Kentucky (53095) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with University Of Kentucky Hospital, and is a graduate of Other (2001).

NPPES Registry Identity

NPI1275735789

Entity TypeIndividualMale

Primary Taxonomy2086X0206X

Provider Legal NamePRAKASH PANDALAICredential: MD

Location Address800 ROSE ST, 1ST FLLexington, KY 40536

Mailing Address8008 Westpark DrMc Lean, VA 22102-3109 · (240) 330-9506

Phone(859) 323-6542

Fax(859) 323-2074

Sole ProprietorYes

Medical School CMSOtherGraduated 2001

Enumeration DateJune 5, 2007

Last NPPES UpdateMay 5, 20213 updates tracked since enumeration

NPPES CertifiedMay 5, 2021

✔ NPI 1275735789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Surgical OncologyAllopathic & Osteopathic Physicians

Taxonomy Code2086X0206X

Licenses✔ Licensed in KY · 53095✔ Licensed in KY · TP594

Definition

A surgical oncologist is a well-qualified surgeon who has obtained additional training and experience in the multidisciplinary approach to the prevention, diagnosis, treatment, and rehabilitation of cancer patients, and devotes a major portion of his or her professional practice to these activities and cancer research.

Also ListedSurgeryTaxonomy 208600000X · License 35085025 (OH)

800 ROSE ST, Lexington, KY 40536

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Home State Health, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Prakash Pandalai Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4789751959

PECOS Enrollment IDI20190808000722

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

48 services35 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

31 services31 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

27 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Kentucky Hospital

Acute Care Hospitals · Lexington, KY

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number180067

Location800 Rose StreetLexington, KY 40536 · Fayette County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40536 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$162.27 typical visit price

range $52.76 – $162.27

Typical copayment $40.56 (range $13.19 – $40.56)

Most-billed visit code 99205

Established Patient

$66.24 typical visit price

range $16.53 – $131.99

Typical copayment $16.56 (range $4.13 – $32.99)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. JEREMY WAYNE THACKER M.D.

Radiology (Diagnostic Radiology)

800 ROSE ST, HX-302 UKMC
LEXINGTON, KY 40536

Fayette County (859) 257-4457

DR. KIRK PHILLIP HEITMAN M.D.

Pathology (Anatomic Pathology & Clinical Pathology)

800 ROSE ST, MS117
LEXINGTON, KY 40536

Fayette County (859) 257-1446

HARISH RAM MD

Anesthesiology

800 ROSE ST
LEXINGTON, KY 40536

Fayette County (859) 323-5956

MS. YVONNE P RICE APRN NP-C

Nurse Practitioner (Family)

800 ROSE ST
LEXINGTON, KY 40536

Fayette County (859) 218-1779

VANESSA D. SMITH MD

Pathology (Anatomic Pathology)

800 ROSE ST
LEXINGTON, KY 40536

Fayette County (859) 323-6183

JASMINE HOWARD APRN

Nurse Practitioner (Acute Care)

800 ROSE ST, MN604
LEXINGTON, KY 40536

Fayette County (859) 323-6047

MITCHELL ALEXANDER MIGUEL M.D.

Hospitalist

800 ROSE ST
LEXINGTON, KY 40536

Fayette County (859) 323-6047

LEAH RAY YEAGER APRN

Nurse Practitioner (Family)

800 ROSE ST, CC417
LEXINGTON, KY 40536

Fayette County (859) 257-1223

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prakash Pandalai's NPI number?

The NPI number for Prakash Pandalai is 1275735789. It was assigned to this individual provider in the NPPES registry on June 5, 2007.

Where is Prakash Pandalai located?

Prakash Pandalai practices at 800 Rose St 1st Fl, Lexington, KY 40536. The listed phone number is (859) 323-6542.

What is Prakash Pandalai's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Surgical Oncology, with taxonomy code 2086X0206X.

Is Prakash Pandalai enrolled in Medicare?

Yes. Prakash Pandalai is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Prakash Pandalai accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Home State Health and Ambetter of Tennessee list Prakash Pandalai as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Prakash Pandalai affiliated with any hospitals?

According to CMS data, Prakash Pandalai is affiliated with University Of Kentucky Hospital.

When was this NPI record last updated?

The NPPES record for Prakash Pandalai was last updated on May 5, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.