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MELANIE NILUPUL WATHUGALA MD
NPI 1841855525
Family Medicine in Sacramento, CA

Active since May 07, 2019PECOS EnrolledAccepts Medicare Assignment
4860 Y STREET SUITE 1600, SACRAMENTO, CA 95817(916) 734-3630 Get Directions Write a Review

NPPES record last updated: August 17, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 17, 2023, Jul 7, 2022, May 7, 2019 (3 updates tracked since 2019).

About Melanie Nilupul Wathugala Md NPPES

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

MELANIE NILUPUL WATHUGALA MD (NPI 1841855525) is an individual family medicine provider in Sacramento, California, licensed in Massachusetts (290867) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Sacramento, and is a graduate of University Of Southern California Keck School Of Medicine (2019).

NPPES Registry Identity

NPI1841855525
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMELANIE NILUPUL WATHUGALACredential: MD
Location Address4860 Y STREET SUITE 1600Sacramento, CA 95817
Mailing Address4860 Y Street Suite 1600Sacramento, CA 95817
Phone(916) 734-3630
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2019
Enumeration DateMay 7, 2019
Last NPPES UpdateAugust 17, 20233 updates tracked since enumeration
NPPES CertifiedJuly 14, 2023
✔ NPI 1841855525 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in MA · 290867✔ Licensed in CA · 187166
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4860 Y STREET SUITE 1600, Sacramento, CA 95817
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Secondary Practice Location 1

Location 11500 21st StSacramento, CA 95811-5216 · Phone (916) 443-3299

Other Identifiers 1

Medicaid280443MA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Taro Health.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

Melanie Nilupul Wathugala 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 ID6901270685
PECOS Enrollment IDI20230808001635
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 Reassignments

2

Medicare enrollment records show Melanie Wathugala reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regents Of The Univ Of Ca
Same address
Maternal & Fetal Medicine
4860 Y ST
Sacramento, CA 95817
  • Reassigned Medicare billing, California enrollment
  • 2,570 clinicians in this Medicare group
NPI 1013906973 (916) 734-6930
Cares Community Health
1.7 mi
Federally Qualified Health Center (FQHC)
1500 21ST ST
Sacramento, CA 95814
  • Reassigned Medicare billing, California enrollment
  • 68 clinicians in this Medicare group
NPI 1447297379 (916) 443-3299

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

Areas of Expertise CMS Part B claims 4

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.

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.
103 services82 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.
76 services62 patients
Telephone medical discussion with physician, 11-20 minutes 99442
This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.
17 services15 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
15 services15 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95817 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
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.

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 Melanie Wathugala's NPI number?

The NPI number for Melanie Wathugala is 1841855525. It was assigned to this individual provider in the NPPES registry on May 7, 2019.

Where is Melanie Wathugala located?

Melanie Wathugala practices at 4860 Y Street Suite 1600, Sacramento, CA 95817. The listed phone number is (916) 734-3630.

What is Melanie Wathugala's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Melanie Wathugala enrolled in Medicare?

Yes. Melanie Wathugala 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 organizations bill Medicare for Melanie Wathugala's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Melanie Wathugala reassigns Medicare benefits to 2 organizations: Regents Of The Univ Of Ca (Sacramento, CA) and Cares Community Health (Sacramento, CA). Each 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 Melanie Wathugala's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Melanie Wathugala accept?

Health plans from Taro Health list Melanie Wathugala 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.

When was this NPI record last updated?

The NPPES record for Melanie Wathugala was last updated on August 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years 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.