Individual provider Active NPI

Upali Sanath Walgama, MD

  • Internal Medicine Physician
  • Henderson, TX
National Provider Identifier
1265577175
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
F0066 Issued in TX
Practice address
105 N High St
Henderson, TX 75652-3133
Phone
(903) 392-8259
NPI assigned
Feb 20, 2007
Last updated
Oct 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X F0066 TX Primary

Addresses

Primary practice location

105 N High St
Henderson, TX 75652-3133

Mailing address

105 N High St
Henderson, TX 75652-3133
Phone (903) 392-8259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20111026000041 TX Practitioner - Internal Medicine 9436322187 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1966
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henderson Family Medicine, PLLCGroup PAC ID 7113059155, 5 clinicians

Practice addresses (Care Compare)

105 N High St
Henderson Family Medicine
Henderson, TX 75652-3133
Phone (903) 392-8259

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F0066TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson Hospital, LLC Internal Medicine Current Accepting new patients
Henderson Hospital, LLC CurrentSince Mar 1, 2018 Accepting new patients
Henderson Hospital, LLC CurrentSince Mar 1, 2018 Accepting new patients
Henderson Family Medicine, PLLC CurrentSince Sep 1, 2015 Accepting new patients

Locations

105 N High St
Henderson, TX 75652
Phone (903) 392-8259

300 Wilson St
Henderson, TX 75652
Phone (903) 655-6536

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: upaliwalgama@hfmp-tx.direct.office.nextgen.com

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 1

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": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1265577175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N HIGH ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756523133",
            "telephone_number": "903-392-8259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N HIGH ST",
            "city": "HENDERSON",
            "state": "TX",
            "postal_code": "756523133",
            "telephone_number": "903-392-8259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALGAMA",
        "first_name": "UPALI",
        "middle_name": "SANATH",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F0066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, TX

Sources for this page

Verify at the official NPI Registry.