ABHINEET UPPAL M.D.
NPI 1841511219
Colon & Rectal Surgery in Houston, TX

Active since June 18, 2010PECOS EnrolledAccepts Medicare Assignment
81.38/100
CMS Quality Rating
1515 HOLCOMBE BLVD, HOUSTON, TX 77030(713) 792-6161 Get Directions Write a Review

NPPES record last updated: September 3, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Sep 3, 2024, Oct 30, 2020, Jul 15, 2020 and 1 more (4 updates tracked since 2017).

About Abhineet Uppal M.d. NPPES

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

ABHINEET UPPAL M.D. (NPI 1841511219) is an individual colon & rectal surgery provider in Houston, Texas, licensed in Texas (S7359) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS, is affiliated with Emory University Hospital Midtown, and is a graduate of University Of North Carolina At Chapel Hill School Of Medicine (2010).

NPPES Registry Identity

NPI1841511219
Entity TypeIndividualMale
Primary Taxonomy208C00000X
Provider Legal NameABHINEET UPPALCredential: M.D.
Location Address1515 HOLCOMBE BLVDHouston, TX 77030-4000
Mailing AddressPo Box 4439Houston, TX 77210-4439 · (713) 792-2991
Sole ProprietorNo
Medical School CMSUniversity Of North Carolina At Chapel Hill School Of MedicineGraduated 2010
Enumeration DateJune 18, 2010
Last NPPES UpdateSeptember 3, 20244 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2024
NPI 1841511219 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

Primary SpecialtyColon & Rectal SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208C00000X
License Licensed in TX · S7359
Definition

A colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease.

Also ListedSurgeryTaxonomy 208600000X · License S7359 (TX), 125.057844 (IL), 93637 (GA)
Also ListedSurgery · Surgical OncologyTaxonomy 2086X0206X · License 146488 (CA)
1515 HOLCOMBE BLVD, Houston, TX 77030

Other Identifiers 2

Medicaid415248001TX
Other415248002TX · Medicaid-cshcn

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

Abhineet Uppal M.d. 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 ID5092010710
PECOS Enrollment IDI20241127004347
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 5

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.

Diagnostic exam of lower portion of large bowel using a flexible endoscope 45330
This procedure, known as a sigmoidoscopy, involves using a flexible tube with a camera to examine the lower part of your large bowel. It helps in identifying issues like inflammation, ulcers, or abnormal growths. It's a safe, minimally invasive procedure.
26 services18 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services19 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.
16 services14 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.
16 services15 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Emory University Hospital Midtown

Acute Care Hospitals · Atlanta, GA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110078
Location550 Peachtree Street, NEAtlanta, GA 30308 · Fulton County
Emergency services Birthing friendly

Saint Joseph's Hospital Of Atlanta, Inc

Acute Care Hospitals · Atlanta, GA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number110082
Location5665 Peachtree Dunwoody RoadAtlanta, GA 30342 · Fulton County
Emergency services

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
$90.40 typical visit price
range $58.24 – $176.98
Typical copayment $22.60 (range $14.56 – $44.24)
Most-billed visit code 99203
Established Patient
$72.62 typical visit price
range $18.60 – $143.93
Typical copayment $18.15 (range $4.65 – $35.98)
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.

81.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality81.25
Promoting Interoperability100
Improvement Activities40
Cost49.97

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Ostomy deodorant, with or without lubricant, for use in ostomy pouch, per fluid ounce A4394
DME-Orthotic Devices · category DF010N
7 suppliers18 claims355 services$2.49 avg. paid by Medicare
Ostomy pouch, drainable, with barrier attached, with filter (1 piece), each A4424
DME-Orthotic Devices · category DF010N
7 suppliers17 claims350 services$4.52 avg. paid by Medicare
Adhesive remover, wipes, any type, each A4456
DME-Medical/Surgical Supplies · category DA000N
5 suppliers11 claims625 services$0.23 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

Psychiatry & Neurology (Neurology)
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Internal Medicine (Nephrology)
1515 HOLCOMBE BLVD, 77030-4009
HOUSTON, TX 77030
Surgery
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Pathology (Anatomic Pathology & Clinical Pathology)
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Anesthesiology
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Internal Medicine (Medical Oncology)
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Physician Assistant
1515 HOLCOMBE BLVD
HOUSTON, TX 77030
Nurse Practitioner
1515 HOLCOMBE BLVD
HOUSTON, TX 77030

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 Abhineet Uppal's NPI number?

The NPI number for Abhineet Uppal is 1841511219. It was assigned to this individual provider in the NPPES registry on June 18, 2010.

Where is Abhineet Uppal located?

Abhineet Uppal practices at 1515 Holcombe Blvd, Houston, TX 77030. The listed phone number is (713) 792-6161.

What is Abhineet Uppal's specialty?

The primary specialty registered for this NPI is Colon & Rectal Surgery with taxonomy code 208C00000X.

Is Abhineet Uppal enrolled in Medicare?

Yes. Abhineet Uppal 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 Abhineet Uppal accept?

Health plans from Blue Cross and Blue Shield of Texas list Abhineet Uppal 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 Abhineet Uppal affiliated with any hospitals?

According to CMS data, Abhineet Uppal is affiliated with Emory University Hospital Midtown and Saint Joseph's Hospital Of Atlanta, Inc.

When was this NPI record last updated?

The NPPES record for Abhineet Uppal was last updated on September 3, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.