DR. NIHAL HERATH (MD) – Neurology Physician, NPI 1972578466
Neurology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
509 NEUROLOGY in WI
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Provider Addresses for DR. NIHAL HERATH (MD)
PO BOX 735044
CHICAGO, IL 606735044
Phone: (800) 326-2250
Type: Mailing
3301 W FOREST HOME AVE
MILWAUKEE, WI 532152843
Phone: (262) 329-1000
Type: Mailing
American Avenue, Waukesha, Waukesha County, Wisconsin, 53188, United States
WAUKESHA, WI 531885071
Phone: (262) 928-8200
Type: Mailing
975 PORT WASHINGTON RD
GRAFTON, WI 530249201
Phone: (262) 329-1000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2005-03-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050310000108 | I | Neurology | WI | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99233 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes | 143 | 90 | $0 |
| 99223 | Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes | 110 | 106 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 31 | 31 | $0 |
| 99232 | Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes | 13 | 13 | $0 |
Insurance plans in this area (ZIP 60673)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | WI | |
| Diagnostic Radiology | WI | |
| - | WI | |
| Family Practice | IL | |
| - | WI | |
| E N D O C R I N O L O G Y | IL | |
| Family Practice | PA | |
| Cardiovascular Disease (Cardiology) | WI | |
| - | WI | |
| Family Practice | IL |
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