Upali Walgama, MD
NPI 1265577175 · Internal Medicine Physician · Henderson, TX
Enrolled with Medicare as Practitioner - Internal Medicine · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Upali Walgama, MD is a Internal Medicine Physician provider in Henderson, TX (NPI 1265577175).
Provider details
- NPI number
- 1265577175
- Entity type
- Individual
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- Yes
- License
- F0066 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure25% of score
19 yrs in NPPES registry
- Profile completeness25% of score
100% of core fields populated
- Practice footprint15% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)25% of score
252 Medicare services, 2024 (ranked within specialty)
- Open Payments transparency10% of score
Has Open Payments disclosures (2024)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our .
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Established Patient Office Or Other Outpatient Visit With Moderate Level of Decision Making, If Using Time, 30 Minutes Or More99214 | 135 | $123 |
| Visit Complexity Inherent to Evaluation and Management Associated With Medical Care Services That Serve As the Continuing Focal Point for All Needed Health Care Services And/Or With Medical Care Services That Are Part of Ongoing Care Related to a Patient'SG2211 | 56 | $16 |
| Insertion of Needle Into Vein for Collection of Blood Sample36415 | 41 | $9 |
| Established Patient Office Or Other Outpatient Visit With Low Level OD Decision Making, If Using Time, 20 Minutes Or More99213 | 20 | $87 |
Typical Medicare-allowed amounts for these services range $9–$123 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
What this provider prescribes (Medicare Part D)
Top drugs by Medicare Part D claim volume, 2024 · 50 distinct drugs on file.
| Drug | Part D claims (2024) | Beneficiaries |
|---|---|---|
| Hydrocodone/Acetaminophenbrand: Hydrocodone-Acetaminophen | 117 | 17 |
| Atorvastatin Calcium | 85 | 23 |
| Alprazolam | 68 | — |
| Acetaminophen With Codeinebrand: Acetaminophen-Codeine | 54 | — |
| Metoprolol Succinate | 46 | 13 |
| Clonidine Hcl | 43 | — |
Transparency — industry payments
Based on CMS Open Payments, 2024; not all care is captured.
$521 across 27 records (Open Payments 2024)
Open Payments discloses payments and transfers of value (meals, travel, consulting, research, royalties) from drug and device makers to providers. This is a transparency signal, not a verdict — such payments are legal and common, and their presence is neither an endorsement nor a criticism. Source: CMS Open Payments, program year 2024.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-02-20
- Last updated
- 2024-10-17
- Certified
- 2024-10-17
Frequently asked questions
- What is Upali Walgama's NPI number?
- Upali Walgama's National Provider Identifier (NPI) is 1265577175, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Upali Walgama's specialty?
- Upali Walgama is listed in the NPPES registry with a primary specialty of Internal Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Upali Walgama located?
- Upali Walgama's practice location on file with NPPES is 105 N High St, Henderson, TX 75652-3133.
- What is Upali Walgama's phone number?
- The practice phone number listed in the NPPES registry for Upali Walgama is (903) 392-8259.
- Does Upali Walgama accept Medicare?
- Upali Walgama is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Upali Walgama's NPI active?
- Yes — Upali Walgama's NPI (1265577175) is active in the NPPES registry as of the last update on 2024-10-17.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.