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DR. JEFFREY A HEROLD M.D.
NPI 1932394962
Plastic Surgery in Sheboygan, WI

Active since September 12, 2007PECOS EnrolledAccepts Medicare Assignment
94.61/100
CMS Quality Rating
1526 N TAYLOR DR, SHEBOYGAN, WI 53081(920) 803-1598(920) 803-1599 Get Directions Write a Review

NPPES record last updated: February 18, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jeffrey A Herold M.d. NPPES

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

DR. JEFFREY A HEROLD M.D. (NPI 1932394962) is an individual plastic surgery provider in Sheboygan, Wisconsin, licensed in Wisconsin (39578) and active in the NPI registry since September 2007. He is enrolled in Medicare PECOS, is affiliated with St Nicholas Hospital, and is a graduate of University Of Virginia School Of Medicine (1990).

NPPES Registry Identity

NPI1932394962
Entity TypeIndividualMale
Primary Taxonomy208200000X
Provider Legal NameDR. JEFFREY A HEROLDCredential: M.D.
Location Address1526 N TAYLOR DRSheboygan, WI 53081-1927
Mailing Address1526 N Taylor DrSheboygan, WI 53081-1927 · (920) 803-1598 · Fax (920) 803-1599
Phone(920) 803-1598
Fax(920) 803-1599
Sole ProprietorNo
Medical School CMSUniversity Of Virginia School Of MedicineGraduated 1990
Enumeration DateSeptember 12, 2007
Last NPPES UpdateFebruary 18, 2013
✔ NPI 1932394962 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
License✔ Licensed in WI · 39578
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
Also ListedPlastic Surgery · Surgery of the HandTaxonomy 2082S0105X · License 39578 (WI)
1526 N TAYLOR DR, Sheboygan, WI 53081
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Other Identifiers 2

Medicaid32429800WI
Medicare UPING75060WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Network Health, Security Health Plan.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. Jeffrey 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 ID7517924764
PECOS Enrollment IDI20041221000032
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 8

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
146 services76 patients
Injection into tendon or ligament 20550
An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.
82 services51 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
69 services69 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.
53 services45 patients
Aspiration and/or injection of fluid from small joint 20600
This procedure involves inserting a thin needle into a small joint to remove (aspirate) or inject fluid. It can help diagnose conditions, relieve discomfort, or administer medication directly into the joint. It's generally safe with minimal discomfort.
38 services25 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.
37 services34 patients

Hospital Affiliations CMS Care Compare 2

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

St Nicholas Hospital

Acute Care Hospitals · Sheboygan, WI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number520044
Location3100 Superior AveSheboygan, WI 53081 · Sheboygan County
Emergency services Birthing friendly

St Vincent Hospital

Acute Care Hospitals · Green Bay, WI
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number520075
Location835 S Van Buren StGreen Bay, WI 54301 · Brown County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53081 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
$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.

94.61/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality85.17
Promoting Interoperability100
Improvement Activities40

Other Providers at the Same Location NPPES 5

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

MARY J SHOLTEN FIRST ASSIST
Specialist/Technologist, Other (Surgical Assistant)
1526 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
JENNA ARONSON CST
Specialist/Technologist, Other (Surgical Technologist)
1526 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 457-2100
GREAT LAKES PLASTIC SURGERY SC
Plastic Surgery
1526 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 803-1598
ST NICHOLAS HOSPITAL -SISTERS OF THIRD ORDER OF ST FRANCIS
Durable Medical Equipment & Medical Supplies
1526 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700
CARLOS A NIEVES III PA-C
Physician Assistant
1526 N TAYLOR DR
SHEBOYGAN, WI 53081
Sheboygan County (920) 496-4700

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 Jeffrey Herold's NPI number?

The NPI number for Jeffrey Herold is 1932394962. It was assigned to this individual provider in the NPPES registry on September 12, 2007.

Where is Jeffrey Herold located?

Jeffrey Herold practices at 1526 N Taylor Dr, Sheboygan, WI 53081. The listed phone number is (920) 803-1598.

What is Jeffrey Herold's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

Is Jeffrey Herold enrolled in Medicare?

Yes. Jeffrey 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 Jeffrey Herold accept?

Health plans from Anthem Blue Cross and Blue Shield, Network Health and Security Health Plan list Jeffrey 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 Jeffrey Herold affiliated with any hospitals?

According to CMS data, Jeffrey Herold is affiliated with St Nicholas Hospital and St Vincent Hospital.

When was this NPI record last updated?

The NPPES record for Jeffrey Herold was last updated on February 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.