MR. MATHEW PATRICK HERBST MD
NPI 1811020969
Family Medicine in Waunakee, WI

Q: What is Mathew Herbst's NPI number?

The NPI number for Mathew Herbst is 1811020969. It was assigned to this individual provider in the NPPES registry on March 14, 2007.

Q: What is Mathew Herbst's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Mathew Herbst was last updated on November 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since March 14, 2007PECOS EnrolledAccepts Medicare Assignment

1300 S CENTURY AVE, WAUNAKEE, WI 53597(608) 849-4315(608) 850-1606 Get Directions Write a Review

NPPES record last updated: November 23, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 23, 2020, Jun 22, 2018, Feb 10, 2017 (3 updates tracked since 2017).

On this page

About Mr. Mathew Patrick Herbst Md NPPES

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

MR. MATHEW PATRICK HERBST MD (NPI 1811020969) is an individual family medicine provider in Waunakee, Wisconsin, licensed in Wisconsin (66597-20) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS, is affiliated with Ssm Health St Clare Hospital - Baraboo, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1811020969

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMR. MATHEW PATRICK HERBSTCredential: MD

Location Address1300 S CENTURY AVEWaunakee, WI 53597

Mailing Address1100 Delaplaine Ct, Attn: Educational ServicesMadison, WI 53715-1840

Phone(608) 849-4315

Fax(608) 850-1606

Sole ProprietorNo

Medical School CMSOtherGraduated 2015

Enumeration DateMarch 14, 2007

Last NPPES UpdateNovember 23, 20203 updates tracked since enumeration

NPPES CertifiedNovember 23, 2020

✔ NPI 1811020969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WI · 66597-20

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.

Also ListedPhysical TherapistTaxonomy 225100000X · License 10762-024 (WI)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1300 S CENTURY AVE, Waunakee, WI 53597

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Other Identifiers 1

Medicaid1811020969WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Mr. Mathew Patrick Herbst 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 ID7911000468

PECOS Enrollment IDI20180716001054

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 18

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.

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.

251 services140 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.

186 services122 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

115 services115 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

88 services40 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.

80 services70 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

61 services61 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

54 services54 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

30 services16 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test 85027

A complete blood cell count (CBC) is an automated test that measures different components of the blood, including red cells, white cells, and platelets. It helps assess overall health, detect disorders like anemia or infection, and monitor medical treatments.

29 services28 patients

Manual urinalysis test with examination using microscope, automated 81001

A manual urinalysis test with automated microscopic examination is a lab process that checks your urine for health indicators. It involves a machine scanning your sample to identify any abnormal elements, which can assist in diagnosing various conditions.

27 services23 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

24 services24 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

22 services18 patients

Hospital discharge day management, more than 30 minutes 99239

Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.

19 services19 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

18 services14 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

18 services18 patients

Diabetes outpatient self-management training services, individual, per 30 minutes G0108

This service involves personalized training sessions, each lasting 30 minutes, to help manage diabetes. It includes guidance on monitoring blood sugar, healthy eating, physical activity, medication usage, and dealing with daily challenges of living with diabetes.

15 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

13 services13 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

13 services13 patients

Hospital Affiliations CMS Care Compare 4

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

Ssm Health St Clare Hospital - Baraboo

Acute Care Hospitals · Baraboo, WI

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520057

Location707 14th StBaraboo, WI 53913 · Sauk County

Emergency services Birthing friendly

Ssm Health St Mary's Hospital - Madison

Acute Care Hospitals · Madison, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520083

Location700 South Park StMadison, WI 53715 · Dane County

Emergency services Birthing friendly

Sauk Prairie Hospital

Acute Care Hospitals · Prairie Du Sac, WI

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number520095

Location260 26th StreetPrairie Du Sac, WI 53578 · Sauk 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 53597 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

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

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

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier12 claims12 services$169.80 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 17

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

MR. JOHN J BEATY P.T.

Physical Therapist

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

WILLIAM H RANUM MD

Family Medicine

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

DEAN RETAIL SERVICES, INC.

Technician/Technologist (Optician)

1300 S CENTURY AVE, SUITE 200
WAUNAKEE, WI 53597

Dane County (608) 849-4315

NOELLE K. DOWLING MD

Family Medicine

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

SUZANNE J DYNNESON APNP

Nurse Practitioner

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

MISS KELLY M WISCH NP

Nurse Practitioner

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

BARBARA J SCHLITTLER PA-C

Physician Assistant

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

CHRISTINE M DISCH APNP

Nurse Practitioner

1300 S CENTURY AVE
WAUNAKEE, WI 53597

Dane County (608) 849-4315

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 Mathew Herbst's NPI number?

The NPI number for Mathew Herbst is 1811020969. It was assigned to this individual provider in the NPPES registry on March 14, 2007.

Where is Mathew Herbst located?

Mathew Herbst practices at 1300 S Century Ave, Waunakee, WI 53597. The listed phone number is (608) 849-4315.

What is Mathew Herbst's specialty?

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

Is Mathew Herbst enrolled in Medicare?

Yes. Mathew Herbst 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 Mathew Herbst accept?

Health plans from Anthem Blue Cross and Blue Shield list Mathew Herbst 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 Mathew Herbst affiliated with any hospitals?

According to CMS data, Mathew Herbst is affiliated with Ssm Health St Clare Hospital - Baraboo, Ssm Health St Mary's Hospital - Madison, Sauk Prairie Hospital and University Of Wi Hospitals & Clinics Authority.

When was this NPI record last updated?

The NPPES record for Mathew Herbst was last updated on November 23, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.