DR. MATTHEW R HERALD M.D.
NPI 1275737199
Psychiatry & Neurology - Psychiatry in Waukesha, WI
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
Specialties & Licenses
Secondary Practice Location 1
Accepted 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
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.
Medicare Billing Reassignments
4Medicare enrollment records show Matthew Herald reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Waukesha, WI 53188
- Reassigned Medicare billing, Wisconsin enrollment
- 528 clinicians in this Medicare group
Waukesha, WI 53188
- Reassigned Medicare billing, Wisconsin enrollment
- Medicare enrollment name: Bcs Of Wisconsin Sc
- 31 clinicians in this Medicare group
Waukesha, WI 53188
- Reassigned Medicare billing, Wisconsin enrollment
- 18 clinicians in this Medicare group
Watertown, WI 53098
- Reassigned Medicare billing, Wisconsin enrollment
- 215 clinicians in this Medicare group
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 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.
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, WIPhysician 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.
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.
Other Providers at the Same Location NPPES 16
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
WAUKESHA, WI 53188
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.
Which organizations bill Medicare for Matthew Herald's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Herald reassigns Medicare benefits to 4 organizations: Prohealth Medical Group Inc (Waukesha, WI), Bcs Of Wisconsin S.C. (Waukesha, WI), Cary J Kohlenberg MD Sc (Waukesha, WI) and Watertown Physician Practices LLC (Watertown, WI). 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 Matthew Herald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Matthew Herald accept?
Health plans from Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Dean Health Plan, Network Health and UnitedHealthcare 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 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.
# Dr. Matthew R Herald, M.D. · NPI 1275737199
Psychiatry physician in Waukesha, Wisconsin. Individual provider, active in the CMS NPPES registry since June 13, 2007.
## Identity
- **NPI:** 1275737199 (Entity type: Individual)
- **Enumerated:** June 13, 2007
- **Primary specialty:** Psychiatry & Neurology - Psychiatry · taxonomy 2084P0800X
- **State license:** 52333 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 721 AMERICAN AVE STE 501, Waukesha, WI 53188-5071
- **Phone:** (262) 928-7528 · **Fax:** (262) 928-5096
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 4 organizations under Medicare reassignment (form CMS-855R): Prohealth Medical Group Inc (NPI 1629225677, Waukesha, WI); Bcs Of Wisconsin S.C. (NPI 1629579149, Waukesha, WI); Cary J Kohlenberg MD Sc (NPI 1952487506, Waukesha, WI); Watertown Physician Practices LLC (NPI 1225412265, Watertown, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Medical School At San Antonio, class of 2007
## Record status
- **NPPES last updated:** October 9, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1275737199) · Data from the CMS NPPES public registry.