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DR. MATTHEW R HERALD M.D.
NPI 1275737199
Psychiatry & Neurology - Psychiatry in Waukesha, WI

Active since June 13, 2007PECOS EnrolledAccepts Medicare Assignment
100/100
CMS Quality Rating
721 AMERICAN AVE STE 501, WAUKESHA, WI 53188(262) 928-7528(262) 928-5096 Get Directions Write a Review

NPPES record last updated: October 9, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Matthew R Herald M.d. NPPES

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

DR. MATTHEW R HERALD M.D. (NPI 1275737199) is an individual psychiatry provider in Waukesha, Wisconsin, licensed in Wisconsin (52333) and active in the NPI registry since June 2007. He is enrolled in Medicare PECOS, is affiliated with Waukesha Memorial Hospital, and maintains a secondary practice location in Summit.

NPPES Registry Identity

NPI1275737199
Entity TypeIndividualMale
Primary Taxonomy2084P0800X
Provider Legal NameDR. MATTHEW R HERALDCredential: M.D.
Location Address721 AMERICAN AVE STE 501Waukesha, WI 53188-5071
Mailing Address721 American Ave Ste 501Waukesha, WI 53188-5071 · (262) 928-7528 · Fax (262) 928-5096
Phone(262) 928-7528
Fax(262) 928-5096
Sole ProprietorNo
Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2007
Enumeration DateJune 13, 2007
Last NPPES UpdateOctober 9, 2023
NPPES CertifiedOctober 9, 2023
✔ NPI 1275737199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in WI · 52333
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
721 AMERICAN AVE STE 501, Waukesha, WI 53188
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Secondary Practice Location 1

Location 136500 Aurora DrSummit, WI 53066-4899 · Phone (414) 454-6779 · Fax (608) 890-7127

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Medica and more.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. Matthew R Herald 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 ID7810166824
PECOS Enrollment IDI20110809000328
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 2

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.
120 services56 patients
Psychiatric diagnostic evaluation with medical services 90792
A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.
45 services45 patients

Hospital Affiliations CMS Care Compare

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

Waukesha Memorial Hospital

Acute Care Hospitals · Waukesha, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520008
Location725 American AveWaukesha, WI 53188 · Waukesha County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53188 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
$163.24 typical visit price
range $53.90 – $163.24
Typical copayment $40.81 (range $13.47 – $40.81)
Most-billed visit code 99205
Established Patient
$67.37 typical visit price
range $17.40 – $133.76
Typical copayment $16.84 (range $4.35 – $33.44)
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.

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

Other Providers at the Same Location NPPES 15

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

AMANDA J DOWLING PCIT
Counselor (Professional)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
LISA DREW
Nurse Practitioner (Psychiatric/Mental Health)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
MR. NIKKI SEAN KRONER APNP
Nurse Practitioner (Psychiatric/Mental Health)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
KATHLEEN BALL LCSW
Social Worker (Clinical)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
CARRIE LAUX LCSW
Social Worker (Clinical)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
ELLEN M MAJOWSKI LCSW
Social Worker (Clinical)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
JULIANNE M KACZMAREK LCSW
Social Worker (Clinical)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036
MS. JANINE ALLISON KOLINSKI APNP, CARN-AP
Nurse Practitioner (Psychiatric/Mental Health)
721 AMERICAN AVE STE 501
WAUKESHA, WI 53188
Waukesha County (262) 928-4036

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 Matthew Herald's NPI number?

The NPI number for Matthew Herald is 1275737199. It was assigned to this individual provider in the NPPES registry on June 13, 2007.

Where is Matthew Herald located?

Matthew Herald practices at 721 American Ave Ste 501, Waukesha, WI 53188. The listed phone number is (262) 928-7528.

What is Matthew Herald's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Matthew Herald enrolled in Medicare?

Yes. Matthew Herald 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 Matthew Herald accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Medica, Network Health and Providence Health Plan and 1 other insurer list Matthew Herald 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 Matthew Herald affiliated with any hospitals?

According to CMS data, Matthew Herald is affiliated with Waukesha Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Matthew Herald was last updated on October 9, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.