Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

AJAY GAALLA MD
NPI 1104837772
Internal Medicine - Cardiovascular Disease in Victoria, TX

Active since August 10, 2006PECOS EnrolledAccepts Medicare Assignment
99.15/100
CMS Quality Rating
2104 PATTERSON DR, VICTORIA, TX 77901(361) 580-2200(361) 580-2201 Get Directions Write a Review

NPPES record last updated: June 25, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 1, 2026, Aug 25, 2022, Feb 15, 2022 (3 updates tracked since 2022).

About Ajay Gaalla Md NPPES

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

AJAY GAALLA MD (NPI 1104837772) is an individual cardiovascular disease provider in Victoria, Texas, licensed in Texas (J4134) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS, is affiliated with De Tar Hospital Navarro, and is a graduate of University Of Texas Medical School At Houston (1992).

NPPES Registry Identity

NPI1104837772
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameAJAY GAALLACredential: MD
Location Address2104 PATTERSON DRVictoria, TX 77901-5639
Mailing Address2104 Patterson DrVictoria, TX 77901-5639 · (361) 580-2200 · Fax (361) 580-2201
Fax(361) 580-2201
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At HoustonGraduated 1992
Enumeration DateAugust 10, 2006
Last NPPES UpdateJune 25, 20263 updates tracked since enumeration
NPPES CertifiedJune 25, 2026
NPI 1104837772 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in TX · J4134
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
2104 PATTERSON DR, Victoria, TX 77901

Other Identifiers 2

Medicaid113733305TX
Other8DD946TX · Bcbs

Accepted 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

Ajay Gaalla 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 ID7618937137
PECOS Enrollment IDI20070327000230
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 25

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.

Injection, regadenoson, 0.1 mg J2785
Regadenoson injection, 0.1 mg, is a medication used to help visualize the heart during a stress test. It works by increasing blood flow in the arteries of the heart. It's injected into a vein and is generally well-tolerated.
1,562 services390 patients
Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306
This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.
586 services568 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
460 services422 patients
Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision and review by physician 93015
An exercise or drug-induced heart stress test with ECG is a procedure performed by a doctor to assess how your heart responds to exertion. It involves monitoring your heart's electrical activity while you exercise or after medication is given to mimic exercise effects.
422 services420 patients
Rubidium rb-82, diagnostic, per study dose, up to 60 millicuries A9555
Rubidium Rb-82 is a radioactive drug used in a PET scan to help visualize the heart. It helps detect areas with poor blood flow, aiding in diagnosing heart conditions. The dose is up to 60 millicuries per study.
356 services354 patients
Nuclear medicine studies of blood flow in heart muscle at rest and with stress 78492
Nuclear medicine studies help visualize blood flow in your heart at rest and during stress. A small amount of radioactive substance is injected, which your heart absorbs. Images are then taken to assess your heart's health and function.
355 services354 patients

Hospital Affiliations CMS Care Compare 3

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

De Tar Hospital Navarro

Acute Care Hospitals · Victoria, TX
4/5 CMS rating
OwnershipProprietary
CMS Certification Number450147
Location506 E San Antonio StVictoria, TX 77901 · Victoria County
Emergency services Birthing friendly

Cuero Regional Hospital

Acute Care Hospitals · Cuero, TX
OwnershipGovernment - Hospital District or Authority
CMS Certification Number450597
Location2550 N EsplanadeCuero, TX 77954 · De Witt County
Emergency services Birthing friendly

Memorial Medical Center

Critical Access Hospitals · Port Lavaca, TX
OwnershipGovernment - Local
CMS Certification Number451356
Location701 N Virginia StPort Lavaca, TX 77979 · Calhoun County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77901 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
$126.40 typical visit price
range $54.84 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
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.

99.15/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities40

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
64%1,592 patients3/55-star benchmark: 100%
Coronary Artery Disease (CAD): Antiplatelet Therapy
Percentage of patients aged 18 years and older with a diagnosis of coronary artery disease (CAD) seen within a 12 month period who were prescribed aspirin or clopidogrel
58%2,210 patients1/55-star benchmark: 100%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,769 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
77%696 patients3/55-star benchmark: 100%
Ischemic Vascular Disease (IVD): Use of Aspirin or Another Antiplatelet
Percentage of patients 18 years of age and older who were diagnosed with acute myocardial infarction (AMI), coronary artery bypass graft (CABG) or percutaneous coronary interventions (PCI) in the 12 months prior to the measurement period, or who had an active…
62%1,772 patients3/55-star benchmark: 100%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%131 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
97%746 patients4/55-star benchmark: 100%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%2,243 patients5/55-star benchmark: 100%
Preventive Care and Screening: Unhealthy Alcohol Use: Screening & Brief Counseling
Percentage of patients aged 18 years and older who were screened for unhealthy alcohol use using a systematic screening method at least once within the last 24 months AND who received brief counseling if identified as an unhealthy alcohol user
100%403 patients5/55-star benchmark: 100%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
82%746 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
2%746 patients1/55-star benchmark: 79%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 5

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

Internal Medicine (Cardiovascular Disease)
2104 PATTERSON DR
VICTORIA, TX 77901
Internal Medicine (Cardiovascular Disease)
2104 PATTERSON DR
VICTORIA, TX 77901
Internal Medicine (Cardiovascular Disease)
2104 PATTERSON DR
VICTORIA, TX 77901
Internal Medicine (Interventional Cardiology)
2104 PATTERSON DR
VICTORIA, TX 77901
Internal Medicine (Cardiovascular Disease)
2104 PATTERSON DR
VICTORIA, TX 77901

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 Ajay Gaalla's NPI number?

The NPI number for Ajay Gaalla is 1104837772. It was assigned to this individual provider in the NPPES registry on August 10, 2006.

Where is Ajay Gaalla located?

Ajay Gaalla practices at 2104 Patterson Dr, Victoria, TX 77901. The listed phone number is (361) 580-2200.

What is Ajay Gaalla's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Ajay Gaalla enrolled in Medicare?

Yes. Ajay Gaalla 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 Ajay Gaalla accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 3 other insurers list Ajay Gaalla 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 Ajay Gaalla affiliated with any hospitals?

According to CMS data, Ajay Gaalla is affiliated with De Tar Hospital Navarro, Cuero Regional Hospital and Memorial Medical Center.

When was this NPI record last updated?

The NPPES record for Ajay Gaalla was last updated on June 25, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 46 days 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.