Nihal Herath, MD
NPI 1972578466 · Neurology Physician · Grafton, WI
Enrolled with Medicare as Practitioner - Neurology · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1972578466
- Entity type
- Individual
- Primary specialty
- Neurology PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 40848 (WI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Other Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
20 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
232 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, at Least 50 Minutes99233 | 110 | $103 |
| Initial Hospital Care With Moderate Level of Medical Decision Making, If Using Time, at Least 75 Minutes99223 | 106 | $155 |
| Initial Hospital Care With Straightforward Or Low-Level Medical Decision Making, If Using Time, at Least 55 Minutes99222 | 16 | $120 |
Typical Medicare-allowed amounts for these services range $103–$155 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-02-20
- Last updated
- 2024-04-23
- Certified
- 2024-04-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.