Active NPI 1568457224 Individual Practitioner Male Practitioner

Dr. John Gaines , MD

Internal Medicine • Smithfield, RI

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. John Gaines, MD is a certified Internal Medicine practicing in Smithfield, RI. With approximately 41 years of clinical experience since graduating from State University Of New York At Stony Brook, School Of Medicine in 1985, Dr. Gaines delivers high-quality medical care to the local community at 41 SANDERSON RD.

Dr. Gaines is affiliated with Coastal Medical Physicians Inc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, routine ekg using at least 12 leads including interpretation and report, telephone medical discussion with physician. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

41 Sanderson Rd
Suite 201

Smithfield, RI 029172602

Telephone 4049490300

Fax 4013697963

Associated Practice Facility / Clinic

🏢 David M. Colannino, Dpm, Inc. Facility NPI 1740355379

Medicare Profile & Education

Medical School

State University Of New York At Stony Brook, School Of Medicine

Graduation Year

1985

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Internal Medicine in Smithfield, RI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

41 Yrs +19.6 yrs vs City Avg

City Avg: 21.4 Yrs

State Avg: 27.9 Yrs

Regional Practice Density

9 Specialists

Practicing in Smithfield, RI (1079 Statewide)

Telehealth Adoption Rate

77.8% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

69.9% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Gaines (41 Years) 41 Yrs

Smithfield Specialty Average (21.4 Years) 21.4 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
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	277	165	$260.00	$86.57
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	147	123	$350.00	$113.96
93000 Routine ekg using at least 12 leads including interpretation and report	79	79	$42.00	$14.42
99442 Telephone medical discussion with physician, 11-20 minutes	45	34	$260.00	$90.15
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	20	20	$327.00	$43.80
G0008 Administration of influenza virus vaccine	14	13	$73.86	$32.68
99213 Established patient office or other outpatient visit, typically 15 minutes	12	12	$170.00	$64.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	241	137	$211.20	$83.83
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	238	222	$286.93	$113.92
93000 Routine ekg using at least 12 leads including interpretation and report	128	123	$53.53	$14.78
90662 Influenza vaccine split virus, preservative free	37	37	$0.50	$0.49
G0008 Administration of influenza virus vaccine	37	37	$65.11	$31.37
G0009 Administration of pneumococcal vaccine	15	15	$52.20	$30.58
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	15	15	$0.50	$0.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	319	208	$190.00	$95.23
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	228	215	$255.00	$108.30
93000 Routine ekg using at least 12 leads including interpretation and report	143	142	$60.00	$14.87
90662 Influenza vaccine split virus, preservative free	34	34	$0.50	$0.49
G0008 Administration of influenza virus vaccine	34	34	$32.00	$30.61
99213 Established patient office or other outpatient visit, typically 15 minutes	27	23	$137.67	$70.45
87428 Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus and influenza	20	19	$95.00	$30.44
G0009 Administration of pneumococcal vaccine	19	19	$30.00	$29.48
90677 Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use	14	14	$0.50	$0.49

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	283	171	$185.90	$78.54
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	163	149	$248.28	$114.70
93000 Routine ekg using at least 12 leads including interpretation and report	92	89	$60.00	$15.52
99213 Established patient office or other outpatient visit, typically 15 minutes	77	66	$125.00	$59.91
G0008 Administration of influenza virus vaccine	24	24	$30.00	$17.73
90662 Influenza vaccine split virus, preservative free	24	24	$0.50	$0.50
91300 Sarscov2 vac 30mcg/0.3ml im	19	19	$0.50	$0.01
0004A Fee covid-19 vac 1 res	19	19	$62.00	$41.63
99496 Transitional care management services for problem of high complexity	13	11	$360.00	$291.00

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	432	275	$180.00	$71.71
93000 Routine ekg using at least 12 leads including interpretation and report	106	99	$60.00	$17.91
G0008 Administration of influenza virus vaccine	98	97	$30.00	$17.62
99213 Established patient office or other outpatient visit, typically 15 minutes	91	74	$125.00	$52.19
90662 Influenza vaccine split virus, preservative free	89	88	$1.72	$1.72
99443 Telephone medical discussion with physician, 21-30 minutes	61	48	$178.20	$112.64
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	29	29	$285.00	$120.65
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	19	17	$240.00	$85.04
99442 Telephone medical discussion with physician, 11-20 minutes	16	14	$125.00	$78.73
94640 Inhalation treatment for airway obstruction or sputum production	13	13	$40.00	$18.74
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	13	13	$10.00	$0.13

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	558	300	$124.83	$51.09
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	547	248	$179.85	$68.74
93000 Routine ekg using at least 12 leads including interpretation and report	212	202	$60.00	$17.96
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	177	168	$239.86	$91.97
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	159	26	$39.75	$17.50
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	159	26	$5.48	$1.01
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	105	105	$285.00	$122.50
94640 Inhalation treatment for airway obstruction or sputum production	70	67	$40.00	$19.26
G0008 Administration of influenza virus vaccine	54	53	$30.00	$17.28
J7620 Albuterol, up to 2.5 mg and ipratropium bromide, up to 0.5 mg, fda-approved final product, non-compounded, administered through dme	48	48	$10.00	$0.14
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	36	36	$235.00	$180.56
G0009 Administration of pneumococcal vaccine	33	33	$30.00	$17.28
90653 Vaccine for influenza for injection into muscle	31	31	$0.50	$0.49
90670 Pneumococcal vaccine for injection into muscle	18	18	$0.50	$0.49
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$5.80	$5.68
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	15	15	$30.00	$16.20
90662 Influenza vaccine split virus, preservative free	14	14	$16.07	$15.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	426	187	$175.00	$97.12
99213 Established patient office or other outpatient visit, typically 15 minutes	357	201	$120.00	$66.83
93000 Routine ekg using at least 12 leads including interpretation and report	190	172	$60.00	$18.49
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	188	166	$235.00	$130.39
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	105	16	$40.00	$22.39
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	105	16	$0.39	$0.08
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	93	93	$211.88	$125.84
94640 Inhalation treatment for airway obstruction or sputum production	56	48	$40.00	$20.36
G0008 Administration of influenza virus vaccine	54	51	$30.00	$21.32
90662 Influenza vaccine split virus, preservative free	50	47	$2.58	$2.49
G0009 Administration of pneumococcal vaccine	35	35	$30.00	$21.32
77080 Dxa bone density measurement of hip, pelvis, spine	27	27	$245.00	$46.79
90670 Pneumococcal vaccine for injection into muscle	20	20	$0.50	$0.49
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	15	15	$0.50	$0.49
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	12	12	$235.00	$176.63

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	425	192	$169.67	$127.67
99213 Established patient office or other outpatient visit, typically 15 minutes	385	200	$115.00	$86.28
93000 Routine ekg using at least 12 leads including interpretation and report	179	163	$60.00	$21.51
G0439 Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit	121	121	$185.00	$155.45
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	96	83	$229.32	$172.26
94640 Inhalation treatment for airway obstruction or sputum production	55	53	$40.00	$23.26
G0008 Administration of influenza virus vaccine	52	52	$30.00	$26.42
G0009 Administration of pneumococcal vaccine	47	47	$30.00	$26.42
96372 Injection beneath the skin or into muscle for therapy, diagnosis, or prevention	43	11	$40.00	$31.93
90662 Influenza vaccine split virus, preservative free	43	43	$1.65	$1.60
J3420 Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg	43	11	$0.94	$0.30
90670 Pneumococcal vaccine for injection into muscle	32	32	$0.50	$0.47
G0438 Annual wellness visit; includes a personalized prevention plan of service (pps), initial visit	18	18	$235.00	$230.29
90732 Vaccine for pneumococcal polysaccharide for injection beneath the skin or into muscle, patient 2 years or older	18	18	$13.75	$13.47
77080 Dxa bone density measurement of hip, pelvis, spine	15	15	$245.00	$55.80
87880 Detection test by immunoassay with direct visual observation for streptococcus, group a (strep)	12	11	$30.00	$16.11

Medical Specialties & State Licenses

CMS Verified: 2024-04-09

Internal Medicine Primary Specialty

NUCC Taxonomy Code: 207R00000X

State License RI MD07187

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

JG18500 (RI)

Commercial Insurance / Payer ID Bcbs Of Ri

428-6 (RI)

Commercial Insurance / Payer ID Blue Chip

202213 (RI)

Commercial Insurance / Payer ID Tufts Health Plan

404476 (RI)

Commercial Insurance / Payer ID United Health Care

04-00477 (RI)

Commercial Insurance / Payer ID Neighborhood Health Plan

20850 (RI)

Commercial Insurance / Payer ID Harvard Health Plan

60537 (RI)

Commercial Insurance / Payer ID Health Care Value Mgmt

751395 (RI)

Commercial Insurance / Payer ID Great West Health Care

050483739 (RI)

Commercial Insurance / Payer ID Medicare Group

709004048 (RI)

Hospital & Practice Group Affiliations

Coastal Medical Physicians Inc

41 Sanderson Rd, Smithfield, RI 029172603

Phone: 4019490300

Practice Associates & Co-Workers

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

17 Associated Practitioners

Dr. David Pugliese , OD

Optometrist

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Doctor of Optometry

Dr. Luis Lopez La Rosa , MD

Internal Medicine

NPI 1104434455

Doctor of Medicine (M.D.)

Sandra Alfred , NP

Nurse Practitioner

NPI 1306831821

Nurse Practitioner

Dr. Vanessa Greenier , MD

Internal Medicine

NPI 1356337745

Doctor of Medicine (M.D.)

Dr. Frank Fraioli , DO

Family Medicine

NPI 1386627248

Doctor of Osteopathic Medicine (D.O.)

Dr. Nidhi Sharma , MD

Internal Medicine

NPI 1407134745

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active February 01, 2011

NPI status registered as active in NPPES database

📍

Updated Practice Location February 01, 2011

Registered at 41 SANDERSON RD, SUITE 201, SMITHFIELD, RI 029172602 (Tel: 4049490300)

📍

Updated Business Mailing Address February 01, 2011

Registered at 10 DAVOL SQ, SUITE 400, PROVIDENCE, RI 029034754 (Tel: 4014214000)

👤

Provider Name / Credentials Updated February 01, 2011

Recorded as JOHN GAINES, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 01, 2011

Internal Medicine (License #MD07187 in RI)

🟢

Initial NPI Registration & Enumeration September 19, 2005

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: 1568457224

Entity Type:

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

Enumeration Date: September 19, 2005

Last Update: April 09, 2024

Sole Proprietor: No

Update or Correct Profile

Mailing Address

10 Davol Sq, Suite 400

Providence, RI 029034754

Phone: 4014214000

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.