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DR. DONALD B MIDDLETON MD
NPI 1609815299
Internal Medicine in Pittsburgh, PA

Active since June 06, 2006PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
3937 BUTLER ST, PITTSBURGH, PA 15201(412) 622-7343(412) 621-8235 Get Directions Write a Review

NPPES record last updated: December 22, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Dr. Donald B Middleton Md NPPES

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

DR. DONALD B MIDDLETON MD (NPI 1609815299) is an individual internal medicine provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (MD020718E) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Rochester School Of Medicine And Dentistry (1972).

NPPES Registry Identity

NPI1609815299
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. DONALD B MIDDLETONCredential: MD
Location Address3937 BUTLER STPittsburgh, PA 15201-3222
Mailing Address139 1st StOakmont, PA 15139-2156 · (412) 596-0944
Phone(412) 622-7343
Fax(412) 621-8235
Sole ProprietorNo
Medical School CMSUniversity Of Rochester School Of Medicine And DentistryGraduated 1972
Enumeration DateJune 6, 2006
Last NPPES UpdateDecember 22, 2020
NPPES CertifiedDecember 22, 2020
✔ NPI 1609815299 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in PA · MD020718E
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License MD020718E (PA)
3937 BUTLER ST, Pittsburgh, PA 15201
Open in Google Maps ↗

Other Identifiers 2

Medicaid0006328020007PA
Other022093PA · Highmark

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

Dr. Donald B Middleton Md 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 ID6305734567
PECOS Enrollment IDI20040309000523
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

2

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

Upmc Community Medicine Inc
1.3 mi
Cardiovascular Disease
5140 LIBERTY AVE
Pittsburgh, PA 15224
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 1,182 clinicians in this Medicare group
NPI 1801179890 (412) 647-5438
Renaissance Family Practice-Upmc,inc
3.9 mi
Cardiovascular Disease
200 DELAFIELD RD, SUITE 3010
Pittsburgh, PA 15215
  • Reassigned Medicare billing, Pennsylvania enrollment
  • 90 clinicians in this Medicare group
NPI 1639325061 (412) 781-4860

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

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.

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.
14 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15201 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
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
Most-billed visit code 99214
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.

78.53/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.61
Promoting Interoperability100
Improvement Activities40
Cost53.82

Other Providers at the Same Location NPPES 20

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

DR. NADINE CHAMPSI MD
Student in an Organized Health Care Education/Training Program
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
ANUJA UTTAM OZA M.D.
Family Medicine
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
DR. JONATHAN MARK KOVAC PHARMD
Pharmacist
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
KAITLIN ANDERSON MD
Student in an Organized Health Care Education/Training Program
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
PARITA RAY MD
Student in an Organized Health Care Education/Training Program
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
SHREYA GITANJALI SHIVAN MD
Student in an Organized Health Care Education/Training Program
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
ARDIS MARIE COPENHAVER PHARMD
Pharmacist
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343
MR. SADIQ HASSAN
Psychiatry & Neurology (Psychiatry)
3937 BUTLER ST
PITTSBURGH, PA 15201
Allegheny County (412) 622-7343

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 Donald Middleton's NPI number?

The NPI number for Donald Middleton is 1609815299. It was assigned to this individual provider in the NPPES registry on June 6, 2006.

Where is Donald Middleton located?

Donald Middleton practices at 3937 Butler St, Pittsburgh, PA 15201. The listed phone number is (412) 622-7343.

What is Donald Middleton's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Donald Middleton enrolled in Medicare?

Yes. Donald Middleton 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 Donald Middleton's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Donald Middleton reassigns Medicare benefits to 2 organizations: Upmc Community Medicine Inc (Pittsburgh, PA) and Renaissance Family Practice-Upmc,inc (Pittsburgh, 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 Donald Middleton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Donald Middleton was last updated on December 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.