2026 NPPES data Specialist NPI 1972578466 MD
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NIHAL HERATH, MD

Specialist in GRAFTON, Wisconsin. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
What the federal data reveals: NIHAL HERATH, MD is a Specialist ([object Object]) practicing in GRAFTON, Wisconsin .

What stands out: NIHAL HERATH, MD specializes in Specialist and practices in GRAFTON, Wisconsin, listed in the federal CMS National Provider Identifier registry. Every detail on this page comes straight from federal CMS records, with no proprietary rating applied.

NIHAL HERATH, MD at a glance

Quality data not reported

NPI registry status

Active

Issued 02/20/2006

NPI 1972578466

Primary specialty

Specialist

High-volume

69,658 US NPIs in this specialty

Specialty distribution in Wisconsin

How Specialist compares to other specialties among Wisconsin providers

Wisconsin providers

Specialist share within Wisconsin

1. Specialist42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Specialist share within Wisconsin

Specialty board-certification context

Estimated specialty board-certified rate — Specialist (ABMS / AOA reference)

Quality data not reported
Est. board-certified rate
78%
Specialist ABMS/AOA estimate

Est. board-certified rate (Specialist) — ABMS / AOA estimate

0%100%78%
Est. board-certified rate (Specialist) — ABMS / AOA estimate

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

NIHAL HERATH, MD is a Specialist provider practicing in GRAFTON, Wisconsin, according to the CMS National Plan and Provider Enumeration System (NPPES). Credentials: MD. NPI: 1972578466. This profile includes practice location, specialty classification, and organizational affiliations from the CMS provider registry. Provider information is self-reported to CMS and updated monthly.

NIHAL HERATH, MD appears in the CMS NPPES registry as a Specialist provider holding MD credentials at 975 PORT WASHINGTON RD, GRAFTON, WI, 53024, with a listed phone of (262) 329-1000. NPI 1972578466 was issued on 02/20/2006. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what HERATH most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D prescribing data is not currently published for this NPI, which typically means the provider either wrote fewer than 11 Part D claims in the most recent reporting year, does not participate in Medicare, or practices in a specialty that rarely prescribes outpatient drugs. Absence of prescribing data is not a quality signal — many Specialist providers operate outside Part D entirely.

Specialist is a high-volume specialty nationwide, with 69,658 enrolled providers across 55 states and an average of 1,474 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

975 PORT WASHINGTON RD
GRAFTON, WI 53024

Provider Details

NPI 1972578466
Specialty Specialist
Credentials MD
Gender Male
NPI Issued 02/20/2006

Hospital and facility affiliations

Facilities where NIHAL HERATH, MD bills Medicare from. Star ratings (1-5) are CMS Hospital Compare's "Hospital overall rating" — a composite of mortality, readmission, patient experience, safety, timely care, and efficient use of medical imaging measures. Source: CMS Care Compare.

AURORA ADVANCED HEALTHCARE, INC.
GRAFTON, WI

Affiliations sourced from CMS Doctors and Clinicians National Downloadable File; hospital ratings from CMS Hospital General Information dataset (cross-referenced by facility name + state).

Specialist Overview

How NIHAL HERATH, MD fits within the Specialist landscape nationally.

69,658
Specialist Providers in US
55
States with Specialist
1,474
Avg Claims per Provider

Nearby Specialist Providers in Wisconsin

Other clinicians with the same primary specialty enrolled in Wisconsin, drawn from the same CMS NPPES roster as HERATH.

Compare Specialist nationally: see state-by-state distribution →

Frequently Asked Questions

What is NIHAL HERATH, MD's specialty?
NIHAL HERATH, MD specializes in Specialist and practices in GRAFTON, Wisconsin. Credentials: MD.
Where is NIHAL HERATH, MD located?
NIHAL HERATH, MD is located at 975 PORT WASHINGTON RD, GRAFTON, WI, 53024. Phone: (262) 329-1000.
What is NIHAL HERATH, MD's NPI number?
NIHAL HERATH, MD's National Provider Identifier (NPI) is 1972578466, issued on 02/20/2006.
How many Specialist providers are there in the US?
There are 69,658 Specialist providers across 55 states in the US. The average Specialist provider writes 1,474 Medicare Part D claims per year.
Does NIHAL HERATH, MD accept Medicare?
NIHAL HERATH, MD appears in CMS Medicare data. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify NIHAL HERATH, MD's credentials?
NIHAL HERATH, MD's NPI is 1972578466 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology