Dr. Sam Gaines , MD
Internal Medicine • Normal, IL
Virginia & Franklin Streets
Normal, IL 61761
This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.
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NPI assigned on June 23, 2006; this date does not establish years in practice.
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Published CMS data list 330 Original Medicare Part B services in 2021.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021. Published rows only; this is not a quality measure.
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Published Part B service records, 2021:
- 99285 — Emergency department visit with high level of medical decision making: 259 service units.
- 99284 — Emergency department visit with moderate level of medical decision making: 48 service units.
- 99283 — Emergency department visit with low level of medical decision making: 23 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2020 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2021). CPT notice
See the full table · Guide: How to read Medicare Part B data
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Published CMS data list 44 Medicare Part D prescriptions, including refills, in 2024.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Published rows only; this is not a quality measure.
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Published Part D records, 2024:
- Buprenorphine-Naloxone (Buprenorphine Hcl/Naloxone Hcl) — 44 prescription fills, including refills.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Drug names come from pharmacy claims. Listing a drug here is not an endorsement or a recommendation.
See the full table · Guide: How to read Medicare Part D prescriber data
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Fewer Part D prescriptions than 85% of clinicians listed under Internal Medicine in Illinois (2024, 3,755 clinicians with data). Median for this group: 1,030. Middle half: 99 to 4,658.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 815 in 2017 to 330 in 2021.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2017–2021.
Practice Location & Contact Primary Location
Virginia & Franklin Streets
Normal, IL 61761
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
What Public CMS Data Show
Internal Medicine: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare-allowed amount
About $55,023 in 2021
The total amount Medicare approved for these services in 2021. It includes what Medicare paid and what patients or their other insurance owed, such as the deductible and coinsurance.
It shows the total cost of this clinician's Original Medicare services under Medicare's fee rules.
What this does not show: Medicare-allowed amount
This is not the clinician's income. Part of it can go to a clinic or group practice, staff, equipment or drugs. It is not the price you will pay.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.
Paid by Medicare
About $45,606 in 2021
The part of the Medicare-allowed amount that Medicare itself paid in 2021, after patients' deductibles and coinsurance.
The gap between the allowed amount and this number is roughly what patients and their other insurance paid.
What this does not show: Paid by Medicare
This is not the clinician's income and not a measure of quality.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2021.
30-day fills
46 standardized 30-day fills in 2024
CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.
What this does not show: 30-day fills
It is not a count of patients and not a measure of quality.
Part D drug cost
$7,423 in 2024
The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.
It shows the total spending on drugs this clinician prescribed, not what any one patient paid.
What this does not show: Part D drug cost
A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.
Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.
Open Payments general payments, program year 2020
All general payments: $31.26 across 2 records.
By nature of payment
- Food and Beverage: $31.26 across 2 records.
Reporting-company totals
- Nabriva Therapeutics, plc: $31.26 across 2 records.
A reported payment does not necessarily mean the financial relationship is improper and is not a measure of care quality. Clinicians can review and dispute these records.
Source: Calculated by T-MedInfo from CMS Open Payments general-payment records for program year 2020 (published June 30, 2026).
NPI first issued
2006
The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.
What this does not show: NPI first issued
NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.
Source: CMS NPPES NPI Registry.
Medicare assignment not listed
CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.
Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.
Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”
No telehealth indicator
CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.
Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.
Enrolled in Medicare (PECOS)
Dr. Gaines has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.
It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Can order Medicare-covered services
CMS lists Dr. Gaines as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.
Medicare pays for these items and services only when they are ordered by an eligible clinician.
What this does not show: Can order Medicare-covered services
It does not mean the clinician offers these services directly.
Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.
Compared with the same specialty in Normal and Illinois
Billing and prescribing volume is not a quality rating.
Medicare Part D prescriptions
Fewer Part D prescriptions than 85% of clinicians listed under Internal Medicine in Illinois (2024, 3,755 clinicians with data). Median for this group: 1,030. Middle half: 99 to 4,658.
Too few clinicians listed under Internal Medicine in Normal have Medicare Part D data for 2024 to compare.
Part D drug cost
A lower Part D drug cost than 70% of clinicians listed under Internal Medicine in Illinois (2024, 3,755 clinicians with data). Median for this group: $78,716. Middle half: $2,604 to $371,507.
Too few clinicians listed under Internal Medicine in Normal have Medicare Part D data for 2024 to compare.
Medicare Part B
Comparisons use 2024 data. The latest CMS data for Dr. Gaines are from 2021.
16 active clinicians are listed under Internal Medicine with a practice address in Normal, IL (7,245 in Illinois).
Addresses are self-reported to NPPES and may be out of date.
Telehealth indicator in Normal
12.5% of these 16 clinicians have the CMS telehealth indicator.
56.2% of these 16 clinicians are listed by CMS as accepting Medicare assignment.
CMS data by year
Changes may reflect reporting, coverage or privacy limits, not changes in care quality.
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Medicare Part B services
Medicare Part B services decreased 60% from 815 in 2017 to 330 in 2021.
- 2017: 815
- 2018: 714
- 2019: 558
- 2020: 541
- 2021: 330
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Medicare-allowed amount
Medicare-allowed amount decreased 58% from $132,554 in 2017 to $55,023 in 2021.
- 2017: $132,554
- 2018: $110,756
- 2019: $88,343
- 2020: $89,092
- 2021: $55,023
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Paid by Medicare
Paid by Medicare decreased 56% from $104,276 in 2017 to $45,606 in 2021.
- 2017: $104,276
- 2018: $86,470
- 2019: $69,383
- 2020: $71,406
- 2021: $45,606
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Medicare Part D prescriptions
Medicare Part D prescriptions decreased 58% from 106 in 2019 to 44 in 2024.
- 2019: 106
- 2020: 80
- 2021: 47
- 2023: 22
- 2024: 44
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30-day fills
30-day fills decreased 57% from 106 in 2019 to 46 in 2024.
- 2019: 106
- 2020: 80
- 2021: 47
- 2023: 22
- 2024: 46
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Part D drug cost
Part D drug cost went from $602 in 2019 to $7,423 in 2024.
- 2019: $602
- 2020: $791
- 2021: $176
- 2023: $6,736
- 2024: $7,423
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $12.07 in 2019 to $31.26 in 2020.
- 2019: $12.07
- 2020: $31.26
Sources: CMS Medicare Physician & Other Practitioners (2021), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2020), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.
Text: T-MedInfo · Report an error.
Pharma & Medical Device Financial Disclosures
Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments
Program year 2020 (payments made January 1 – December 31, 2020): fewer than 11 records totaling $31.26.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Nabriva Therapeutics, plc |
Food and Beverage
In-kind items and services
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Xenleta | General | $15.83 |
| Nabriva Therapeutics, plc |
Food and Beverage
In-kind items and services
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Xenleta | General | $15.43 |
Source: CMS Open Payments, program year 2020, released June 30, 2026.
Performed Procedures & Service Volume
CPT® is a registered trademark of the American Medical Association. CPT codes, descriptions and other data only are copyright 2016–2020 American Medical Association. All rights reserved. Applicable FARS/HHSARS apply. Descriptions of CPT codes are the AMA's CPT Consumer Friendly Descriptors as published by CMS in the Medicare Physician & Other Practitioners – by Provider and Service data, 2017–2021; they are plain-language summaries, not for clinical coding or documentation. HCPCS Level II codes and descriptions are from CMS. Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
| HCPCS Code | Services | Patients | Submitted Charge | Medicare Allowed |
|---|---|---|---|---|
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99285
Emergency department visit with high level of medical decision making
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259 | 242 | $1516.00 | $182.75 |
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99284
Emergency department visit with moderate level of medical decision making
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48 | 48 | $1026.00 | $124.99 |
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99283
Emergency department visit with low level of medical decision making
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23 | 23 | $683.00 | $73.51 |
Source: CMS Part B by Provider and Service, 2021; services under 11 beneficiaries omitted by CMS. Privacy limits
Submitted charges are billed amounts, not a price quote for your visit.
Medicare Part D Prescribing Profile & Medications
Medicare Part D prescriptions filled, including refills, in 2024.
| Brand Name | Generic Name | Prescriptions | Day Supply | Total Cost | Patients |
|---|---|---|---|---|---|
| Buprenorphine-Naloxone | Buprenorphine Hcl/Naloxone Hcl | 44 | 1,297 | $7,423.14 | — |
Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits
Specialties & License Numbers Reported to NPPES
Self-certified to NPPES: 2021-12-28NUCC Taxonomy Code: 207R00000X
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.
NUCC Taxonomy Code: 207P00000X
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
NUCC Taxonomy Code: 207PE0004X
An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - INTERNAL MEDICINE
I20040122001131
IL
3870406861
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Clinicians Sharing This Practice Address or Phone
Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.
Nurse Practitioner
Nurse Practitioner
Emergency Medicine - Emergency Medical Services
Doctor of Osteopathic Medicine (D.O.)
Emergency Medicine - Emergency Medical Services
Doctor of Medicine (M.D.)
Career & Practice History
NPI enumerated June 23, 2006.
No changes to the name, practice address, taxonomy or NPI status in this record have been observed in the monthly NPPES data files from January 2017 to August 2026.
NPI Administrative Meta
Other Internal Medicine Providers in Normal
- Dr. Caroline Halperin, DO
- Dr. Enrique Martinez Trevino, MD
- Dr. Maria Saavedra, MD
- Dr. Gurpreet Singh, MD
- Dr. Anand Oroskar, MD
- Dr. Marlito Favila, MD
Mailing Address
509 Colbrook Dr
Springfield, IL 627023384
Phone: 2177829318