Dr. John Gaines , MD
Internal Medicine • Smithfield, RI
41 Sanderson Rd, Suite 201
Smithfield, RI 029172602
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 September 19, 2005; this date does not establish years in practice.
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Published CMS data list 594 Original Medicare Part B services in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Published rows only; this is not a quality measure.
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Published Part B service records, 2024:
- 99214 — Established patient outpatient office visit: 277 service units.
- 99215 — Established patient outpatient office visit: 147 service units.
- 93000 — Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report: 79 service units.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Units differ by code; these are not visits or a measure of quality.
CPT® only copyright 2023 American Medical Association. All rights reserved. Service names are shortened from CPT Consumer Friendly Descriptors (CMS data, 2024). CPT notice
See all 7 records in the table · Guide: How to read Medicare Part B data
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Published CMS data list 10,545 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:
- Atorvastatin Calcium — 1,117 prescription fills, including refills.
- Rosuvastatin Calcium — 841 prescription fills, including refills.
- Losartan Potassium — 612 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 all 107 records in the table · Guide: How to read Medicare Part D prescriber data
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More Medicare Part B services than 65% of clinicians listed under Internal Medicine in Rhode Island (2024, 529 clinicians with data). Median for this group: 396. Middle half: 234 to 705.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2024. Billing and prescribing volume is not a quality rating.
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Medicare Part B services went from 967 in 2020 to 594 in 2024.
Source: CMS, Medicare Physician & Other Practitioners – by Provider and Service, 2020–2024.
Practice Location & Contact Primary Location
41 Sanderson Rd
Suite 201
Smithfield, RI 029172602
Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.
CMS Doctors and Clinicians lists 1 group name: Coastal Medical Physicians Inc. See the list
Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.
Listings do not confirm current availability, employment or a shared ownership network.
Medicare Profile & Education
Source: CMS Doctors and Clinicians National Downloadable File
State University Of New York At Stony Brook, School Of Medicine
1985
What Public CMS Data Show
Internal Medicine: NPPES taxonomy is a reported classification, not proof of board certification.
Medicare patients
249 people with Original Medicare in 2024
It gives a sense of how many people with Medicare this clinician treated that year.
Source: CMS, Medicare Physician & Other Practitioners – by Provider, 2024.
Medicare-allowed amount
About $48,040 in 2024
The total amount Medicare approved for these services in 2024. 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, 2024.
Paid by Medicare
About $25,713 in 2024
The part of the Medicare-allowed amount that Medicare itself paid in 2024, 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, 2024.
30-day fills
26,230 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
$822,505 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.
Industry payments (Open Payments)
Fewer than 11 payment records totaling $21.82 in 2023
Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.
It shows reported financial ties between this clinician and companies. You can ask your clinician about them.
These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.
General: payments not tied to research, such as meals, travel, consulting or speaking fees.
A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.
Source: CMS Open Payments, program year 2023.
Years since graduation
41 years (graduated 1985)
CMS Doctors and Clinicians data list 1985 as the year this clinician finished professional school.
It tells you roughly how long ago the clinician finished school.
What this does not show: Years since graduation
It is not the number of years in practice, and more years does not mean better care.
Source: CMS Doctors and Clinicians National Downloadable File.
NPI first issued
2005
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.
Accepts Medicare assignment
CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.
With Original Medicare, you usually pay only your deductible and coinsurance, and the office sends the claim to Medicare for you.
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?”
Telehealth (some services)
Recent Medicare claims show this clinician provided some services by telehealth, such as a video or phone visit.
You may be able to have some visits without going to the office. Ask which visits can be done by telehealth.
What this does not show: Telehealth (some services)
It does not mean all services are offered by telehealth, or that telehealth is covered by your plan.
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 Smithfield and Rhode Island
Billing and prescribing volume is not a quality rating.
Medicare Part B services
More Medicare Part B services than 65% of clinicians listed under Internal Medicine in Rhode Island (2024, 529 clinicians with data). Median for this group: 396. Middle half: 234 to 705.
Too few clinicians listed under Internal Medicine in Smithfield have Medicare Part B data for 2024 to compare.
Medicare-allowed amount
A higher Medicare-allowed amount than 60% of clinicians listed under Internal Medicine in Rhode Island (2024, 529 clinicians with data). Median for this group: $38,752. Middle half: $20,970 to $59,070.
Too few clinicians listed under Internal Medicine in Smithfield have Medicare Part B data for 2024 to compare.
Paid by Medicare
Close to the middle for clinicians listed under Internal Medicine in Rhode Island (2024, 529 clinicians with data). Median for this group: $28,221. Middle half: $15,243 to $44,860.
Too few clinicians listed under Internal Medicine in Smithfield have Medicare Part B data for 2024 to compare.
Medicare Part D prescriptions
More Part D prescriptions than 90% of clinicians listed under Internal Medicine in Rhode Island (2024, 581 clinicians with data). Median for this group: 749. Middle half: 91 to 5,119.
Too few clinicians listed under Internal Medicine in Smithfield have Medicare Part D data for 2024 to compare.
Part D drug cost
A higher Part D drug cost than 90% of clinicians listed under Internal Medicine in Rhode Island (2024, 581 clinicians with data). Median for this group: $63,829. Middle half: $3,341 to $358,176.
Too few clinicians listed under Internal Medicine in Smithfield have Medicare Part D data for 2024 to compare.
8 active clinicians are listed under Internal Medicine with a practice address in Smithfield, RI (1,034 in Rhode Island).
Addresses are self-reported to NPPES and may be out of date.
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 39% from 967 in 2020 to 594 in 2024.
- 2020: 967
- 2021: 714
- 2022: 838
- 2023: 711
- 2024: 594
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Medicare-allowed amount
Medicare-allowed amount stayed about the same: $52,997 in 2020 and $48,040 in 2024.
- 2020: $52,997
- 2021: $51,976
- 2022: $61,333
- 2023: $50,853
- 2024: $48,040
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Paid by Medicare
Paid by Medicare decreased 16% from $30,439 in 2020 to $25,713 in 2024.
- 2020: $30,439
- 2021: $27,958
- 2022: $32,461
- 2023: $27,519
- 2024: $25,713
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Medicare Part D prescriptions
Medicare Part D prescriptions increased 55% from 6,786 in 2020 to 10,545 in 2024.
- 2020: 6,786
- 2021: 6,767
- 2022: 10,409
- 2023: 10,815
- 2024: 10,545
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30-day fills
30-day fills increased 56% from 16,832 in 2020 to 26,230 in 2024.
- 2020: 16,832
- 2021: 17,422
- 2022: 26,128
- 2023: 27,339
- 2024: 26,230
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Part D drug cost
Part D drug cost increased 159% from $317,896 in 2020 to $822,505 in 2024.
- 2020: $317,896
- 2021: $358,216
- 2022: $708,609
- 2023: $797,041
- 2024: $822,505
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Industry payments (Open Payments)
Industry payments (Open Payments) went from $34.04 in 2019 to $21.82 in 2023.
- 2019: $34.04
- 2023: $21.82
Sources: CMS Medicare Physician & Other Practitioners (2024), CMS Medicare Part D Prescribers (2024), CMS Open Payments (2023), 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 2023 (payments made January 1 – December 31, 2023): fewer than 11 records totaling $21.82.
| Manufacturer | Payment Nature | Product | Type | Amount ($) |
|---|---|---|---|---|
| Amgen Inc. |
Food and Beverage
In-kind items and services
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Otezla | General | $21.82 |
Source: CMS Open Payments, program year 2023, 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 2016–2023 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, 2017–2024; 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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99214
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more
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277 | 165 | $260.00 | $86.57 |
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99215
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more
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147 | 123 | $350.00 | $113.96 |
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93000
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report
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79 | 79 | $42.00 | $14.42 |
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99442
Telephone medical discussion with physician, 11-20 minutes
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45 | 34 | $260.00 | $90.15 |
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G0439
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit
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20 | 20 | $327.00 | $43.80 |
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G0008
Administration of influenza virus vaccine
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14 | 13 | $73.86 | $32.68 |
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99213
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more
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12 | 12 | $170.00 | $64.87 |
Source: CMS Part B by Provider and Service, 2024; 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 |
|---|---|---|---|---|---|
| Atorvastatin Calcium | Atorvastatin Calcium | 1,117 | 93,284 | $12,234.43 | 312 |
| Rosuvastatin Calcium | Rosuvastatin Calcium | 841 | 62,690 | $12,139.83 | 241 |
| Losartan Potassium | Losartan Potassium | 612 | 50,588 | $7,429.16 | 170 |
| Omeprazole | Omeprazole | 488 | 41,973 | $7,467.43 | 149 |
| Lisinopril | Lisinopril | 447 | 39,569 | $3,756.40 | 131 |
| Amlodipine Besylate | Amlodipine Besylate | 415 | 32,241 | $3,417.82 | 115 |
| Levothyroxine Sodium | Levothyroxine Sodium | 369 | 29,361 | $5,323.91 | 101 |
| Simvastatin | Simvastatin | 362 | 31,455 | $4,435.73 | 101 |
| Hydrochlorothiazide | Hydrochlorothiazide | 355 | 28,250 | $1,439.39 | 95 |
| Metoprolol Succinate | Metoprolol Succinate | 305 | 24,345 | $4,568.28 | 90 |
| Ezetimibe | Ezetimibe | 227 | 17,237 | $5,489.35 | 64 |
| Eliquis | Apixaban | 212 | 9,093 | $171,413.13 | 38 |
| Alendronate Sodium | Alendronate Sodium | 193 | 14,548 | $2,443.46 | 54 |
| Metformin Hcl | Metformin Hcl | 174 | 14,122 | $1,615.86 | 53 |
| Sertraline Hcl | Sertraline Hcl | 163 | 12,495 | $2,106.71 | 49 |
| Albuterol Sulfate Hfa | Albuterol Sulfate | 160 | 4,588 | $4,841.09 | 48 |
| Trulicity | Dulaglutide | 153 | 4,766 | $156,825.21 | 25 |
| Famotidine | Famotidine | 145 | 10,536 | $1,873.01 | 37 |
| Atenolol | Atenolol | 143 | 12,304 | $1,196.83 | 38 |
| Metoprolol Tartrate | Metoprolol Tartrate | 128 | 10,598 | $1,160.29 | 39 |
| Tamsulosin Hcl | Tamsulosin Hcl | 128 | 10,555 | $1,992.49 | 45 |
| Metformin Hcl Er | Metformin Hcl | 121 | 10,216 | $1,388.65 | 39 |
| Gabapentin | Gabapentin | 115 | 7,288 | $1,749.95 | 30 |
| Alprazolam | Alprazolam | 106 | 3,672 | $651.43 | 33 |
| Escitalopram Oxalate | Escitalopram Oxalate | 105 | 8,609 | $1,625.82 | 33 |
(top 25 shown)
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: 2024-04-09NUCC 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.
Additional State Medicaid & Healthcare Payer Identifiers
Medicare (PECOS) Enrollment & Ordering Eligibility
Source: CMS PECOSPRACTITIONER - INTERNAL MEDICINE
I20050414000762
RI
2264479823
Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.
Medicare Group Practice Enrollments
Source: CMS Doctors and Clinicians National Downloadable File
Coastal Medical Physicians Inc
41 Sanderson Rd, Smithfield, RI 029172603
Phone: 4019490300
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
Nurse Practitioner - Family
Nurse Practitioner
Physical Therapist
Doctor of Physical Therapy
Podiatrist
Doctor of Podiatric Medicine
Nurse Practitioner - Family
Nurse Practitioner
Career & Practice History
NPI enumerated September 19, 2005.
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 Smithfield
- Dr. Luis Lopez La Rosa, MD
- Dr. Ryan Rossi, MD
- Dr. Vanessa Greenier, MD
- Dr. Katie Kozacka, MD
- Dr. John Corsi, DO
- Dr. Nidhi Sharma, MD
Mailing Address
10 Davol Sq, Suite 400
Providence, RI 029034754
Phone: 4014214000