DR. KELLY A HEROLD M.D.
NPI 1083818918
Internal Medicine in Madison, WI

Active since June 13, 2007PECOS EnrolledAccepts Medicare Assignment
451 JUNCTION RD, MADISON, WI 53717(608) 265-1600 Get Directions Write a Review

NPPES record last updated: January 5, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Kelly A Herold M.d. NPPES

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

DR. KELLY A HEROLD M.D. (NPI 1083818918) is an individual internal medicine provider in Madison, Wisconsin, licensed in Wisconsin (52539) and active in the NPI registry since June 2007. She is enrolled in Medicare PECOS, is affiliated with Unitypoint Health - Meriter, and is a graduate of Other (2007).

NPPES Registry Identity

NPI1083818918
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameDR. KELLY A HEROLDCredential: M.D.
Location Address451 JUNCTION RDMadison, WI 53717-2656
Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531
Sole ProprietorNo
Medical School CMSOtherGraduated 2007
Enumeration DateJune 13, 2007
Last NPPES UpdateJanuary 5, 2021
NPPES CertifiedJanuary 5, 2021
NPI 1083818918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License Licensed in WI · 52539
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.

451 JUNCTION RD, Madison, WI 53717

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

Dr. Kelly A Herold 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 ID3577741115
PECOS Enrollment IDI20110629000547
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 6

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.
386 services247 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.
121 services100 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
50 services23 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.
37 services31 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.
20 services19 patients
Telephone medical discussion with physician, 21-30 minutes 99443
This service involves a 21-30 minute phone conversation with a physician. It's a chance for you to discuss your health concerns, symptoms or treatment plans. It's similar to an in-person consultation, but conducted over the phone for your convenience and safety.
17 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Unitypoint Health - Meriter

Acute Care Hospitals · Madison, WI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520089
Location202 S Park StMadison, WI 53715 · Dane County
Emergency services Birthing friendly

University Of Wi Hospitals & Clinics Authority

Acute Care Hospitals · Madison, WI
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number520098
Location600 Highland AvenueMadison, WI 53792 · Dane County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53717 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
$123.69 typical visit price
range $53.90 – $163.24
Typical copayment $30.92 (range $13.47 – $40.81)
Most-billed visit code 99204
Established Patient
$95.41 typical visit price
range $17.40 – $133.76
Typical copayment $23.85 (range $4.35 – $33.44)
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.

Referred Medical Equipment & Supplies CMS DME claims 12

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
14 suppliers39 claims135 services$4.75 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
7 suppliers14 claims23 services$0.98 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers23 claims23 services$35.72 avg. paid by Medicare
Pillow for use on nasal cannula type interface, replacement only, pair A7033
DME-Other DME · category DE001N
1 supplier12 claims72 services$13.79 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
1 supplier20 claims20 services$59.34 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
1 supplier20 claims20 services$17.82 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.

Physician Assistant (Medical)
451 JUNCTION RD
MADISON, WI 53717
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717
Internal Medicine (Endocrinology, Diabetes & Metabolism)
451 JUNCTION RD
MADISON, WI 53717
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717
Pharmacy
451 JUNCTION RD, SUITE 9901, ROOM 1191
MADISON, WI 53717
Nurse Practitioner
451 JUNCTION RD
MADISON, WI 53717
Nurse Practitioner
451 JUNCTION RD
MADISON, WI 53717
Internal Medicine
451 JUNCTION RD
MADISON, WI 53717

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 Kelly Herold's NPI number?

The NPI number for Kelly Herold is 1083818918. It was assigned to this individual provider in the NPPES registry on June 13, 2007.

Where is Kelly Herold located?

Kelly Herold practices at 451 Junction Rd, Madison, WI 53717. The listed phone number is (608) 265-1600.

What is Kelly Herold's specialty?

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

Is Kelly Herold enrolled in Medicare?

Yes. Kelly Herold 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 Kelly Herold accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, Group Health Cooperative-SCW, HealthPartners and Quartz and 1 other insurer list Kelly Herold 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 Kelly Herold affiliated with any hospitals?

According to CMS data, Kelly Herold is affiliated with Unitypoint Health - Meriter and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Kelly Herold was last updated on January 5, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.