Active NPI 1972730604 Individual Practitioner Male Practitioner

Dr. Nathan Formaini , DO

Orthopaedic Surgery • Pittsburgh, PA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Nathan Formaini, DO is a certified Orthopaedic Surgery practicing in Pittsburgh, PA. With approximately 17 years of clinical experience since graduating from Lake Erie College Of Osteopathic Medicine, Erie in 2009, Dr. Formaini delivers high-quality medical care to the local community at 200 DELAFIELD RD STE 1040.

Dr. Formaini maintains professional affiliations with Upmc Community Medicine Inc, Phoenix Rehabilitation And Health Services Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, triamcinolone acetonide, not otherwise specified, 10 mg, x-ray of shoulder, minimum of 2 views, aspiration and/or injection of fluid from large joint. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

200 Delafield Rd Ste 1040

Pittsburgh, PA 152153234

Telephone 4127823990

Associated Practice Facility / Clinic

🏢 Upmc Community Medicine Inc Facility NPI 1023145455

Medicare Profile & Education

Medical School

Lake Erie College Of Osteopathic Medicine, Erie

Graduation Year

2009

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Pittsburgh, PA

Established Specialist (10-20 Yrs)

Practitioner Clinical Experience

17 Yrs -3.7 yrs vs City Avg

City Avg: 20.7 Yrs

State Avg: 27.5 Yrs

Regional Practice Density

147 Specialists

Practicing in Pittsburgh, PA (1345 Statewide)

Telehealth Adoption Rate

3.4% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

65.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Formaini (17 Years) 17 Yrs

Pittsburgh Specialty Average (20.7 Years) 20.7 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	916	131	$8.00	$0.98
73030 X-ray of shoulder, minimum of 2 views	246	142	$71.43	$32.13
20610 Aspiration and/or injection of fluid from large joint	175	116	$253.19	$65.61
99213 Established patient office or other outpatient visit, typically 15 minutes	154	129	$153.19	$85.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	62	57	$226.84	$121.91
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	40	40	$224.18	$106.02
73080 X-ray of elbow, minimum of 3 views	34	20	$86.00	$29.85
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	25	$92.80	$51.69
23472 Prosthetic repair of shoulder joint, total shoulder	19	19	$4409.00	$1373.59
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$358.27	$159.47

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	804	113	$8.00	$1.06
73030 X-ray of shoulder, minimum of 2 views	169	108	$71.17	$32.89
20610 Aspiration and/or injection of fluid from large joint	151	108	$252.72	$67.57
99213 Established patient office or other outpatient visit, typically 15 minutes	145	109	$149.00	$87.72
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	50	48	$222.00	$124.26
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	35	35	$222.00	$106.66
23472 Prosthetic repair of shoulder joint, total shoulder	16	16	$4409.00	$1414.29
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$346.00	$162.12
73080 X-ray of elbow, minimum of 3 views	13	12	$86.00	$31.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	424	76	$6.00	$1.13
99213 Established patient office or other outpatient visit, typically 15 minutes	121	87	$128.74	$87.92
20610 Aspiration and/or injection of fluid from large joint	94	76	$202.82	$66.48
73030 X-ray of shoulder, minimum of 2 views	92	69	$60.52	$33.57
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	29	28	$198.10	$125.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	29	29	$212.69	$109.80
73080 X-ray of elbow, minimum of 3 views	19	13	$82.84	$30.53
73130 X-ray of hand, minimum of 3 views	16	11	$66.75	$35.80
73502 X-ray of hip, 2-3 views	15	12	$78.40	$46.21

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
73030 X-ray of shoulder, minimum of 2 views	129	91	$40.00	$33.46
99213 Established patient office or other outpatient visit, typically 15 minutes	106	81	$92.00	$90.33
J1040 Injection, methylprednisolone acetate, 80 mg	94	74	$11.87	$10.53
20610 Aspiration and/or injection of fluid from large joint	90	74	$151.97	$66.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	80	71	$145.00	$128.42
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$240.00	$166.17
73502 X-ray of hip, 2-3 views	27	16	$56.00	$45.48
73562 X-ray of knee, 3 views	17	16	$48.00	$39.36
20550 Injection into tendon or ligament	12	11	$95.33	$53.38
J1020 Injection, methylprednisolone acetate, 20 mg	12	11	$20.00	$3.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
73030 X-ray of shoulder, minimum of 2 views	134	84	$40.00	$32.04
20610 Aspiration and/or injection of fluid from large joint	103	76	$147.84	$62.93
J1040 Injection, methylprednisolone acetate, 80 mg	97	72	$12.00	$11.50
99213 Established patient office or other outpatient visit, typically 15 minutes	81	59	$79.00	$74.07
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	63	56	$145.00	$107.88
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	26	26	$168.00	$106.17
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	25	25	$240.00	$163.60
20550 Injection into tendon or ligament	14	12	$88.00	$48.98
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	13	13	$990.29	$178.50
J1030 Injection, methylprednisolone acetate, 40 mg	13	12	$30.00	$6.02
29823 Removal of extensive shoulder joint tissue using an endoscope	13	13	$1088.00	$159.92
23472 Prosthetic repair of shoulder joint, total shoulder	13	13	$2504.00	$1475.28
73560 X-ray of knee, 1-2 views	13	13	$39.00	$32.30
J1020 Injection, methylprednisolone acetate, 20 mg	12	12	$20.00	$3.57

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	171	109	$79.00	$70.85
20610 Aspiration and/or injection of fluid from large joint	145	86	$151.70	$59.57
J1040 Injection, methylprednisolone acetate, 80 mg	127	83	$12.00	$11.53
73030 X-ray of shoulder, minimum of 2 views	110	72	$40.00	$28.94
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	33	33	$168.00	$105.92
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	25	25	$145.00	$106.29
99202 New patient office or other outpatient visit, typically 20 minutes	24	24	$116.00	$74.46
J1020 Injection, methylprednisolone acetate, 20 mg	19	15	$20.00	$3.80
29823 Removal of extensive shoulder joint tissue using an endoscope	18	17	$1088.00	$199.24
73502 X-ray of hip, 2-3 views	17	14	$56.00	$38.97
73560 X-ray of knee, 1-2 views	14	11	$39.00	$30.90
29827 Repair of shoulder rotator cuff using an endoscope	14	14	$1538.00	$1026.93
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	13	13	$100.00	$72.18
29828 Release of shoulder biceps tendon using an endoscope	13	13	$1139.00	$440.85
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	13	13	$990.29	$178.57
J1030 Injection, methylprednisolone acetate, 40 mg	12	11	$30.00	$6.38

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	261	138	$79.00	$70.69
20610 Aspiration and/or injection of fluid from large joint	157	80	$158.06	$61.00
J1040 Injection, methylprednisolone acetate, 80 mg	140	74	$12.00	$11.82
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	48	46	$145.00	$104.69
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	25	25	$168.00	$105.13
J1020 Injection, methylprednisolone acetate, 20 mg	21	16	$20.00	$4.46
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	21	21	$100.00	$71.79
J1030 Injection, methylprednisolone acetate, 40 mg	17	15	$30.00	$6.66
99202 New patient office or other outpatient visit, typically 20 minutes	14	14	$116.00	$70.01
23472 Prosthetic repair of shoulder joint, total shoulder	13	13	$2504.00	$1457.72
29823 Removal of extensive shoulder joint tissue using an endoscope	11	11	$1088.00	$188.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	232	140	$79.00	$69.75
20610 Aspiration and/or injection of fluid from large joint	187	106	$143.26	$60.09
J1040 Injection, methylprednisolone acetate, 80 mg	160	99	$12.00	$10.86
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	63	63	$168.00	$104.36
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	43	39	$145.00	$103.73
99202 New patient office or other outpatient visit, typically 20 minutes	36	36	$116.00	$72.12
J1030 Injection, methylprednisolone acetate, 40 mg	25	22	$30.00	$5.70
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	23	23	$100.00	$70.85
20550 Injection into tendon or ligament	13	11	$94.77	$51.54
23472 Prosthetic repair of shoulder joint, total shoulder	11	11	$2504.00	$1447.06

Medical Specialties & State Licenses

CMS Verified: 2022-07-05

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License PA OS017449

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.

Orthopaedic Surgery

NUCC Taxonomy Code: 207X00000X

State License FL OS12496

Hospital & Practice Group Affiliations

Phoenix Rehabilitation And Health Services Inc

2000 Westinghouse Dr, Cranberry Township, PA 160665238

Upmc Community Medicine Inc

200 Delafield Rd, Pittsburgh, PA 152153234

Phone: 4127823990

Phoenix Rehabilitation And Health Services Inc

2000 Westinghouse Dr, Cranberry Twp, PA 160665238

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

23 Associated Practitioners

Stevie Jennings , PA-C

Physician Assistant

NPI 1003169350

Physician Assistant (Certified)

Charles Hileman

Physician Assistant - Surgical

NPI 1083948772

Tyler Spreng , PA-C

Physician Assistant

NPI 1255060497

Physician Assistant (Certified)

Mary Purdy

Physician Assistant - Surgical

NPI 1265498174

Dr. Edward Mcclain , MD

Specialist

NPI 1518932243

Doctor of Medicine (M.D.)

Ashley Baird , PA

Physician Assistant

NPI 1538461736

Physician Assistant

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events

📍

Updated Practice Location July 05, 2022

Registered at 200 DELAFIELD RD STE 1040, PITTSBURGH, PA 152153234 (Tel: 4127823990)

📍

Updated Business Mailing Address July 05, 2022

Registered at 200 DELAFIELD RD STE 1040, PITTSBURGH, PA 152153234 (Tel: 4127823990)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2022

Orthopaedic Surgery (License #OS12496 in FL)

✅

NPI Profile Active July 05, 2015

NPI status registered as active in NPPES database

📍

Updated Practice Location July 05, 2015

Registered at 77 GLADE DR, KITTANNING, PA 162017140 (Tel: 9549584800)

📍

Updated Business Mailing Address July 05, 2015

Registered at 700 MEDICAL ARTS BLDG, SUITE 710, KITTANNING, PA 162017141 (Tel: 7245438624)

👤

Provider Name / Credentials Updated July 05, 2015

Recorded as NATHAN FORMAINI, D.O.

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 05, 2015

Orthopaedic Surgery (License #OS017449 in PA)

🟢

Initial NPI Registration & Enumeration June 21, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972730604

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: June 21, 2009

Last Update: July 05, 2022

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

200 Delafield Rd Ste 1040

Pittsburgh, PA 152153234

Phone: 4127823990

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.