RICK FORNELLI M.D.
NPI 1316998263
Otolaryngology in Erie, PA

Q: What is Rick Fornelli's NPI number?

The NPI number for Rick Fornelli is 1316998263. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Q: What is Rick Fornelli's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Rick Fornelli was last updated on December 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 15, 2006PECOS EnrolledAccepts Medicare Assignment

79.55/100

CMS Quality Rating

380 E BAYFRONT PKWY STE 3, ERIE, PA 16507(814) 877-9060(814) 877-9089 Get Directions Write a Review

NPPES record last updated: December 28, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 28, 2022, Apr 27, 2021 (2 updates tracked since 2021).

On this page

About Rick Fornelli M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RICK FORNELLI M.D. (NPI 1316998263) is an individual otolaryngology provider in Erie, Pennsylvania, licensed in Pennsylvania (MD072365L) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Upmc Chautauqua At Wca, and is a graduate of Pennsylvania State University College Of Medicine (1995).

NPPES Registry Identity

NPI1316998263

Entity TypeIndividualMale

Primary Taxonomy207Y00000X

Provider Legal NameRICK FORNELLICredential: M.D.

Location Address380 E BAYFRONT PKWY STE 3Erie, PA 16507-2408

Mailing Address380 E Bayfront Pkwy Ste 3Erie, PA 16507-2408 · (814) 877-9060 · Fax (814) 877-9089

Phone(814) 877-9060

Fax(814) 877-9089

Sole ProprietorNo

Medical School CMSPennsylvania State University College Of MedicineGraduated 1995

Enumeration DateMay 15, 2006

Last NPPES UpdateDecember 28, 20222 updates tracked since enumeration

NPPES CertifiedDecember 28, 2022

✔ NPI 1316998263 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in PA · MD072365L

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

380 E BAYFRONT PKWY STE 3, Erie, PA 16507

Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Cigna Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Rick Fornelli M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3173667482

PECOS Enrollment IDI20110119001072

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Rick Fornelli reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Regional Health Services Inc

0.8 mi

Family Medicine

201 STATE ST
Erie, PA 16550

Reassigned Medicare billing, Pennsylvania enrollment
962 clinicians in this Medicare group

NPI 1174520654 (814) 877-8140

Ear Nose And Throat Specialists Of Northwestern Pennsylvania

1.5 mi

Otolaryngology

1645 W 8TH ST, SUITE 200
Erie, PA 16505

Reassigned Medicare billing, Pennsylvania enrollment
12 clinicians in this Medicare group

NPI 1194754846 (814) 864-9994

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Professional service for preparation and provision of 1 or more antigens 95165

This service involves the creation and supply of antigens, substances that stimulate your immune system to fight diseases. These antigens can be used in vaccines or allergy tests to help your body build defenses against specific health threats.

1,040 services22 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

333 services224 patients

Professional service for multiple injections of allergen 95117

The professional service for multiple injections of allergens involves administering small doses of specific allergens into your body. This is done to help your immune system become less sensitive to them, reducing your allergic reaction over time. It's a safe, effective way to manage allergies.

319 services20 patients

Removal of impacted ear wax 69210

Impacted ear wax removal is a safe procedure to clear blockages in the ear canal caused by hardened ear wax. A healthcare professional uses specialized tools or a gentle irrigation method to loosen and remove the wax, improving hearing and alleviating discomfort.

239 services168 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

117 services117 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

100 services83 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

55 services51 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

45 services45 patients

Diagnostic exam of nasal passages using an endoscope 31231

A diagnostic exam of nasal passages using an endoscope is a non-invasive procedure. A small, flexible tube with a light and camera at the end, called an endoscope, is inserted into the nose. This allows the doctor to view the nasal passages and sinuses, helping to identify any issues.

38 services34 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

28 services23 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

17 services17 patients

Repositioning exercises of head for treatment of dizziness, each day 95992

Repositioning exercises of the head help manage dizziness by training your brain to cope with the signals that trigger this sensation. Daily, gentle movements of the head and body can reduce symptoms and improve balance.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Upmc Chautauqua At Wca

Acute Care Hospitals · Jamestown, NY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number330239

Location207 Foote AvenueJamestown, NY 14701 · Chautauqua County

Emergency services Birthing friendly

Upmc Hamot

Acute Care Hospitals · Erie, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390063

Location201 State StreetErie, PA 16550 · Erie County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 16507 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$126.34 typical visit price

range $54.64 – $166.87

Typical copayment $31.58 (range $13.66 – $41.71)

Most-billed visit code 99204

Established Patient

$68.36 typical visit price

range $17.33 – $135.84

Typical copayment $17.09 (range $4.33 – $33.96)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.55/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

64.36

Promoting Interoperability

100

Improvement Activities

Cost

67.48

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tracheostomy, inner cannula A4623

DME-Orthotic Devices · category DF000N

1 supplier12 claims701 services$6.07 avg. paid by Medicare

Large volume nebulizer, disposable, unfilled, used with aerosol compressor A7007

DME-Other DME · category DE000N

1 supplier11 claims14 services$2.86 avg. paid by Medicare

Filter holder and integrated filter housing, and adhesive, for use as a tracheostoma heat and moisture exchange system, each A7509

DME-Orthotic Devices · category DF000N

1 supplier12 claims720 services$1.36 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DAVID JOHN ADDISON DO

Student in an Organized Health Care Education/Training Program

380 E BAYFRONT PKWY STE 3
ERIE, PA 16507

Erie County (814) 877-9060

DR. SEAN THOMAS CARROLL D.O.

Otolaryngology (Otolaryngology/Facial Plastic Surgery)

380 E BAYFRONT PKWY STE 3
ERIE, PA 16507

Erie County (814) 877-9060

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rick Fornelli's NPI number?

The NPI number for Rick Fornelli is 1316998263. It was assigned to this individual provider in the NPPES registry on May 15, 2006.

Where is Rick Fornelli located?

Rick Fornelli practices at 380 E Bayfront Pkwy Ste 3, Erie, PA 16507. The listed phone number is (814) 877-9060.

What is Rick Fornelli's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Is Rick Fornelli enrolled in Medicare?

Yes. Rick Fornelli is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Rick Fornelli's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Rick Fornelli reassigns Medicare benefits to 2 organizations: Regional Health Services Inc (Erie, PA) and Ear Nose And Throat Specialists Of Northwestern Pennsylvania (Erie, PA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Rick Fornelli's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Rick Fornelli accept?

Health plans from Cigna Healthcare list Rick Fornelli as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Rick Fornelli affiliated with any hospitals?

According to CMS data, Rick Fornelli is affiliated with Upmc Chautauqua At Wca and Upmc Hamot.

When was this NPI record last updated?

The NPPES record for Rick Fornelli was last updated on December 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.