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HIRAL WAGHELA
NPI 1811631617
Internal Medicine in Houston, TX

Active since April 27, 2022PECOS EnrolledAccepts Medicare Assignment
1 BAYLOR PLZ, HOUSTON, TX 77030(713) 566-3600 Get Directions Write a Review

NPPES record last updated: July 24, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: May 7, 2022, Apr 27, 2022 (2 updates tracked since 2022).

About Hiral Waghela NPPES

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

HIRAL WAGHELA (NPI 1811631617) is an individual internal medicine provider in Houston, Texas, licensed in Texas (V6112) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, is affiliated with Baylor University Medical Center, and is a graduate of Texas Tech University Health Science Center School Of Medicine (2022).

NPPES Registry Identity

NPI1811631617
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameHIRAL WAGHELA
Location Address1 BAYLOR PLZHouston, TX 77030-3411
Mailing Address5602 Bay Leaf DrBaytown, TX 77521-7518 · (832) 917-4090
Phone(713) 566-3600
Sole ProprietorNo
Medical School CMSTexas Tech University Health Science Center School Of MedicineGraduated 2022
Enumeration DateApril 27, 2022
Last NPPES UpdateJuly 24, 20252 updates tracked since enumeration
NPPES CertifiedJuly 24, 2025
✔ NPI 1811631617 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TX · V6112
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1 BAYLOR PLZ, Houston, TX 77030
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Hiral Waghela 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 ID1557879095
PECOS Enrollment IDI20250805002158
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.

Medicare Billing Reassignment

Medicare enrollment records show Hiral Waghela reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Healthtexas Provider Network
160 mi
Anesthesiology
100 MEDICAL PKWY
Lakeway, TX 78738
  • Reassigned Medicare billing, Texas enrollment
  • 3,167 clinicians in this Medicare group
NPI 1104714583 (512) 571-5000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Baylor University Medical Center

Acute Care Hospitals · Dallas, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number450021
Location3500 Gaston AveDallas, TX 75246 · Dallas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 77030 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
$134.06 typical visit price
range $58.24 – $176.98
Typical copayment $33.51 (range $14.56 – $44.24)
Most-billed visit code 99204
Established Patient
$102.71 typical visit price
range $18.60 – $143.93
Typical copayment $25.67 (range $4.65 – $35.98)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

BAYLOR COLLEGE OF MEDICINE
General Acute Care Hospital
1 BAYLOR PLZ, SUITE 022D
HOUSTON, TX 77030
Harris County (713) 798-4620
MATTHEW CARROLL
Obstetrics & Gynecology
1 BAYLOR PLZ, BCM610
HOUSTON, TX 77030
Harris County (832) 826-7372
DR. HOLLAND MANON KAPLAN MD
Hospitalist
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (940) 231-1879
SIDRAH SHAH MD
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (713) 798-5928
MICHAEL AZAR MD (PLANNED 5/27/22)
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (713) 798-6376
MICHELE ALEXIS CABEZA MD
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (832) 824-0200
NATHANIEL GREY LOYD
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (405) 834-5432
ANDREA ELIZABETH GULOY
Student in an Organized Health Care Education/Training Program
1 BAYLOR PLZ
HOUSTON, TX 77030
Harris County (832) 824-1170

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 Hiral Waghela's NPI number?

The NPI number for Hiral Waghela is 1811631617. It was assigned to this individual provider in the NPPES registry on April 27, 2022.

Where is Hiral Waghela located?

Hiral Waghela practices at 1 Baylor Plz, Houston, TX 77030. The listed phone number is (713) 566-3600.

What is Hiral Waghela's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Hiral Waghela enrolled in Medicare?

Yes. Hiral Waghela 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.

Which organization bills Medicare for Hiral Waghela's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Hiral Waghela reassigns Medicare benefits to Healthtexas Provider Network (Lakeway, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Hiral Waghela's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Hiral Waghela 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 2 other insurers list Hiral Waghela 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 Hiral Waghela affiliated with any hospitals?

According to CMS data, Hiral Waghela is affiliated with Baylor University Medical Center.

When was this NPI record last updated?

The NPPES record for Hiral Waghela was last updated on July 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.