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DR. NATHAN FORMAINI D.O.
NPI 1972730604
Orthopaedic Surgery in Pittsburgh, PA

Active since June 21, 2009PECOS EnrolledAccepts Medicare Assignment
78.53/100
CMS Quality Rating
200 DELAFIELD RD STE 1040, PITTSBURGH, PA 15215(412) 782-3990 Get Directions Write a Review

NPPES record last updated: July 5, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Nathan Formaini D.o. NPPES

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

DR. NATHAN FORMAINI D.O. (NPI 1972730604) is an individual orthopaedic surgery provider in Pittsburgh, Pennsylvania, licensed in Pennsylvania (OS017449) and active in the NPI registry since June 2009. He is enrolled in Medicare PECOS, is affiliated with Allegheny Valley Hospital, and is a graduate of Lake Erie College Of Osteopathic Medicine, Erie (2009).

NPPES Registry Identity

NPI1972730604
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameDR. NATHAN FORMAINICredential: D.O.
Location Address200 DELAFIELD RD STE 1040Pittsburgh, PA 15215-3234
Mailing Address200 Delafield Rd Ste 1040Pittsburgh, PA 15215-3234 · (412) 782-3990
Phone(412) 782-3990
Sole ProprietorYes
Medical School CMSLake Erie College Of Osteopathic Medicine, ErieGraduated 2009
Enumeration DateJune 21, 2009
Last NPPES UpdateJuly 5, 2022
NPPES CertifiedJuly 5, 2022
✔ NPI 1972730604 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
Licenses✔ Licensed in PA · OS017449✔ Licensed in FL · OS12496
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
200 DELAFIELD RD STE 1040, Pittsburgh, PA 15215
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Nathan Formaini D.o. 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 ID6608094032
PECOS Enrollment IDI20150805007248
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.

Areas of Expertise CMS Part B claims 10

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
916 services131 patients
X-ray of shoulder, minimum of 2 views 73030
An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.
246 services142 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
175 services116 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.
154 services129 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.
62 services57 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.
40 services40 patients

Hospital Affiliations CMS Care Compare 3

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

Allegheny Valley Hospital

Acute Care Hospitals · Natrona, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390032
Location1301 Carlisle StNatrona, PA 15065 · Allegheny County
Emergency services

Upmc St Margaret

Acute Care Hospitals · Pittsburgh, PA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390102
Location815 Freeport RoadPittsburgh, PA 15215 · Allegheny County
Emergency services

Magee Womens Hospital Of Upmc Health System

Acute Care Hospitals · Pittsburgh, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number390114
Location300 Halket StreetPittsburgh, PA 15213 · Allegheny County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 15215 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
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.

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

Referred Medical Equipment & Supplies CMS DME claims 2

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

Standard wheelchair K0001
DME-Wheelchairs · category DD000N
1 supplier12 claims12 services$17.27 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
1 supplier12 claims12 services$8.02 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 8

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

CHARLES HILEMAN
Physician Assistant (Surgical)
200 DELAFIELD RD STE 1040, UPMC HILLMAN CANCER CENTER-2ND FLOOR
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
TYLER JAMES SPRENG PA-C
Physician Assistant
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
ASHLEY E. BAIRD PA
Physician Assistant
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
DR. LEE MONTGOMERY SASALA MD
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
MS. LAUREN LABRA PA-C
Physician Assistant (Surgical)
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
LORI GAYDOSH
Physician Assistant (Surgical)
200 DELAFIELD RD STE 1040, SUITE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
DR. JOSEPH J KROMKA MD
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990
WENDY FUSAN CRNP
Nurse Practitioner
200 DELAFIELD RD STE 1040
PITTSBURGH, PA 15215
Allegheny County (412) 782-3990

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 Nathan Formaini's NPI number?

The NPI number for Nathan Formaini is 1972730604. It was assigned to this individual provider in the NPPES registry on June 21, 2009.

Where is Nathan Formaini located?

Nathan Formaini practices at 200 Delafield Rd Ste 1040, Pittsburgh, PA 15215. The listed phone number is (412) 782-3990.

What is Nathan Formaini's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Nathan Formaini enrolled in Medicare?

Yes. Nathan Formaini 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.

Is Nathan Formaini affiliated with any hospitals?

According to CMS data, Nathan Formaini is affiliated with Allegheny Valley Hospital, Upmc St Margaret and Magee Womens Hospital Of Upmc Health System.

When was this NPI record last updated?

The NPPES record for Nathan Formaini was last updated on July 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.