Individual provider Active NPI

Matthew R Herald, M.D.

  • Psychiatry Physician
  • Waukesha, WI
National Provider Identifier
1275737199
Registry record updated Oct 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
52333 Issued in WI
Practice address
721 American Ave Ste 501
Waukesha, WI 53188-5071
Phone
(262) 928-7528
Fax
(262) 928-5096
NPI assigned
Jun 13, 2007
Last updated
Oct 9, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 52333 WI Primary

Addresses

Primary practice location

721 American Ave Ste 501
Waukesha, WI 53188-5071

Mailing address

721 American Ave Ste 501
Waukesha, WI 53188-5071
Phone (262) 928-7528

Other practice location 1

36500 Aurora Dr
Summit, WI 53066-4899
Phone (414) 454-6779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110809000328 WI Practitioner - Psychiatry 7810166824 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of Texas Medical School at San Antonio, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Prohealth Medical Group IncGroup PAC ID 3476465188, 475 clinicians

Practice addresses (Care Compare)

721 American Ave
Suite 501
Waukesha, WI 53188-5071
Phone (262) 928-4036

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
52333WIMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cary J Kohlenberg MD SC Psychiatry CurrentSince Dec 1, 2023 Accepting new patients
Prohealth Medical Group Inc. CurrentSince Sep 1, 2023 Accepting new patients
Watertown Physician Practices LLC Current Accepting new patients
BCS of Wisconsin S.C. Psychiatry CurrentSince Sep 12, 2023 Accepting new patients
Watertown Physician Practices LLC CurrentSince Jul 14, 2018 Accepting new patients
Prohealth Medical Group Inc Past Accepting new patients

Locations

39465 W 14 Mile Rd
Novi, MI 48377
Phone 24885939000

845 Highway NN E
Mukwonago, WI 53149
Phone (262) 363-6830

36500 Aurora Dr
Summit, WI 53066
Phone (262) 434-1000

123 Hospital Dr
Ste 110
Watertown, WI 53098
Phone (920) 261-0672

1507 Doctors Ct
Watertown, WI 53094
Phone (920) 261-4111

2717 N Grandview Blvd
Ste 102
Waukesha, WI 53188
Phone (262) 513-0700

721 American Ave
Ste 501
Waukesha, WI 53188
Phone (262) 928-2396

2717 N Grandview Blvd
Ste 202
Waukesha, WI 53188
Phone (262) 513-0700

N17W24100 Riverwood Dr
Waukesha, WI 53188
Phone (262) 820-3093

Interoperability endpoints

  • Direct secure messaging: mherald46611@direct.phci.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696809600000",
    "number": "1275737199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE STE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-7528",
            "fax_number": "262-928-5096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 AMERICAN AVE STE 501",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531885071",
            "telephone_number": "262-928-7528",
            "fax_number": "262-928-5096"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "36500 Aurora Dr",
            "address_purpose": "LOCATION",
            "city": "Summit",
            "state": "WI",
            "postal_code": "530664899",
            "country_code": "US",
            "telephone_number": "414-454-6779",
            "fax_number": "608-890-7127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERALD",
        "first_name": "MATTHEW",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2023-10-09",
        "certification_date": "2023-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WI",
            "license": "52333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waukesha, WI

Sources for this page

Verify at the official NPI Registry.