NPIMap

Individual provider Active NPI

Jeffrey A Herold, M.D.

  • Plastic Surgery Physician
  • Sheboygan, WI
National Provider Identifier
1932394962
Registry record updated Feb 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
39578 Issued in WI
Practice address
1526 N Taylor Dr
Sheboygan, WI 53081-1927
Phone
(920) 803-1598
Fax
(920) 803-1599
NPI assigned
Sep 12, 2007
Last updated
Feb 18, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 39578 WI Primary
Surgery of the Hand (Plastic Surgery) Physician 2082S0105X 39578 WI

Addresses

Primary practice location

1526 N Taylor Dr
Sheboygan, WI 53081-1927

Mailing address

1526 N Taylor Dr
Sheboygan, WI 53081-1927
Phone (920) 803-1598

Other identifiers 1

IdentifierTypeStateIssuer
32429800MedicaidWI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041221000032 WI Practitioner - Plastic and Reconstructive Surgery 7517924764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Plastic and Reconstructive Surgery
Education
University of Virginia School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1526 N Taylor Dr
Sheboygan, WI 53081-1927
Phone (920) 457-2100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.81 of 100Reported as apm
Quality
85.98
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of tissue1-10
Removal of skin lesions1-10
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
39578WIMDPlastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St. Nicholas Hospital-Sisters of the Third Order of St Francis Plastic Surgery Current Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 6, 2011 Accepting new patients
St Nicholas Hospital-Sisters of the Third Order of St Francis CurrentSince Sep 6, 2011 Accepting new patients
Great Lakes Plastic Surgery SC Plastic Surgery PastSince May 20, 1998 Accepting new patients

Locations

1440 N 25th St
Sheboygan, WI 53081
Phone (920) 457-3737

1526 N Taylor Dr
Sheboygan, WI 53081
Phone (920) 457-2100

3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710

Organizations & group practices 4

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 7

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": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361145600000",
    "number": "1932394962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811927",
            "telephone_number": "920-803-1598",
            "fax_number": "920-803-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 N TAYLOR DR",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530811927",
            "telephone_number": "920-803-1598",
            "fax_number": "920-803-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEROLD",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-12",
        "last_updated": "2013-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "WI",
            "license": "39578",
            "primary": true
        },
        {
            "code": "2082S0105X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "WI",
            "license": "39578",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "32429800",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sheboygan, WI

Sources for this page

Verify at the official NPI Registry.