RICK GAINES M.D.
NPI 1437544400
Internal Medicine - Cardiovascular Disease in Cincinnati, OH

Q: What is Rick Gaines's NPI number?

The NPI number for Rick Gaines is 1437544400. It was assigned to this individual provider in the NPPES registry on April 6, 2015.

Q: What is Rick Gaines's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Q: When was this NPI record last updated?

The NPPES record for Rick Gaines was last updated on August 19, 2021. 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.

Active since April 06, 2015PECOS EnrolledAccepts Medicare Assignment

90.38/100

CMS Quality Rating

8240 NORTHCREEK DR STE 4300, CINCINNATI, OH 45236(513) 246-2400 Get Directions Write a Review

NPPES record last updated: August 19, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 19, 2021, Jun 30, 2021, Oct 31, 2019 and 1 more (4 updates tracked since 2018).

On this page

About Rick Gaines M.d. NPPES

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

RICK GAINES M.D. (NPI 1437544400) is an individual cardiovascular disease provider in Cincinnati, Ohio, licensed in Ohio (35.142801) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, is affiliated with Mccullough-hyde Memorial Hospital, and maintains a secondary practice location in Maywood.

NPPES Registry Identity

NPI1437544400

Entity TypeIndividualMale

Primary Taxonomy207RC0000X

Provider Legal NameRICK GAINESCredential: M.D.

Location Address8240 NORTHCREEK DR STE 4300Cincinnati, OH 45236-2379

Mailing Address4685 Forest AveCincinnati, OH 45212-3397 · (513) 246-1964

Phone(513) 246-2400

Sole ProprietorNo

Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2015

Enumeration DateApril 6, 2015

Last NPPES UpdateAugust 19, 20214 updates tracked since enumeration

NPPES CertifiedAugust 19, 2021

✔ NPI 1437544400 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians

Taxonomy Code207RC0000X

Licenses✔ Licensed in OH · 35.142801✔ Licensed in MI · 4301115369

Definition

An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Also ListedInternal MedicineTaxonomy 207R00000X · License 125066360 (IL)

8240 NORTHCREEK DR STE 4300, Cincinnati, OH 45236

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Secondary Practice Location 1

Location 12160 S 1st Ave, Room 7609Maywood, IL 60153 · Phone (708) 216-8563 · Fax (708) 216-1259

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, Oscar Health Insurance.Insurance ›

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

Rick Gaines M.d. 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 ID9830490101

PECOS Enrollment IDI20210825003942

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 24

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.

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.

328 services239 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

This is a heart ultrasound, also known as an echocardiogram. It uses sound waves to create pictures of your heart, showing how blood flows through it. The color depicts the blood flow's speed and direction. It also checks the heart's valves to ensure they're working properly.

312 services308 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

249 services214 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

180 services107 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

155 services150 patients

Ultrasound of heart with color-depicted blood flow, rate and valve function 93325

An ultrasound of the heart, also known as an echocardiogram, uses sound waves to create pictures of your heart. It shows the structure, movement, and blood flow within your heart. This helps assess the heart's health and function, including the valves and rate.

91 services88 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

83 services62 patients

Ultrasound of heart, follow-up 93308

A follow-up ultrasound of the heart, also known as an echocardiogram, is a non-invasive test that uses sound waves to create images of your heart. It helps doctors monitor your heart's function and structures after initial assessment or treatment.

77 services73 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

77 services77 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with supervision by physician 93016

An exercise or drug-induced heart stress test with ECG involves monitoring your heart's activity while it's under stress, either from exercise or medication. A doctor supervises the entire procedure to ensure safety and accuracy in results. This test helps detect heart problems.

68 services68 patients

Exercise or drug-induced heart stress test with electrocardiogram (ecg) with review by physician 93018

An exercise or drug-induced heart stress test with ECG is a procedure to assess how your heart functions under stress. It can involve exercising or medication to make your heart work harder while an ECG records its activity. A physician reviews the results.

68 services68 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

64 services58 patients

Ultrasound of heart blood flow, valves and chambers, follow-up 93321

This procedure, an echocardiogram, uses sound waves to create images of your heart. It aids in assessing your heart's blood flow, chambers, and valves. It's a follow-up procedure, ensuring that your heart is functioning properly post-treatment.

54 services53 patients

Ct scan of blood vessels and grafts of heart with contrast 75574

A CT scan of the heart's blood vessels and grafts with contrast is a diagnostic test. A special dye (contrast) is injected into your veins, which helps create clear images of your heart's vessels and grafts. This helps doctors detect blockages or other abnormalities.

39 services39 patients

External shock to heart to regulate heart beat 92960

This procedure, known as cardioversion, uses an external electrical shock to restore your heart's normal rhythm. It's typically performed when irregular heartbeats, or arrhythmias, are causing severe symptoms and aren't responding to medications.

35 services34 patients

Ultrasound of heart with probe in esophagus, with report 93312

This procedure, called a transesophageal echocardiogram, uses a small probe passed into your esophagus to capture detailed images of your heart. The report provides information about your heart's structure and function.

34 services34 patients

Telephone medical discussion with physician, 11-20 minutes 99442

This is a service where you have a phone conversation with your doctor for 11-20 minutes. It's used for discussing health concerns, reviewing test results, or managing ongoing conditions. It's a convenient way to receive medical advice without an in-person visit.

32 services32 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

26 services26 patients

Nuclear medicine studies of heart muscle at rest and with stress and spect 78452

Nuclear medicine studies of the heart involve two parts: rest and stress. During rest, images are taken of your heart at ease. During stress, images are taken after exercise or medication-induced stress. SPECT is a special imaging technique providing 3D pictures of your heart, helping identify any issues.

23 services23 patients

Ultrasound of heart blood flow, valves and chambers 93320

An ultrasound of your heart, also known as an echocardiogram, is a test that uses sound waves to create detailed images of your heart. It helps doctors check the health of your heart's chambers, valves, and blood flow.

22 services22 patients

Ultrasound of heart with color-depicted blood flow, rate, direction and valve function 93306

20 services20 patients

New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more 99205

This is a first-time patient visit where a healthcare professional spends 60-74 minutes with you. It involves a comprehensive evaluation, including your medical history and current health condition. They'll also advise on preventive health measures and formulate a treatment plan if needed.

17 services17 patients

Ct scan of blood vessels and grafts of heart with contrast 75574

12 services12 patients

Heart muscle strain imaging 93356

Heart muscle strain imaging is a non-invasive test that uses sound waves to create pictures of your heart. It helps doctors evaluate how well your heart muscle is working and detect any damage or disease. This can aid in diagnosing heart conditions and guiding treatment plans.

11 services11 patients

Hospital Affiliations CMS Care Compare 4

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

Mccullough-Hyde Memorial Hospital

Acute Care Hospitals · Oxford, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360046

Location110 North Poplar StreetOxford, OH 45056 · Butler County

Emergency services Birthing friendly

Good Samaritan Hospital

Acute Care Hospitals · Cincinnati, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360134

Location375 Dixmyth AvenueCincinnati, OH 45220 · Hamilton County

Emergency services Birthing friendly

Bethesda North

Acute Care Hospitals · Cincinnati, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360179

Location10500 Montgomery RoadCincinnati, OH 45242 · Hamilton County

Emergency services Birthing friendly

Highland District Hospital

Critical Access Hospitals · Hillsboro, OH

2/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number361332

Location1275 North High StreetHillsboro, OH 45133 · Highland County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45236 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

$126.12 typical visit price

range $54.34 – $166.65

Typical copayment $31.53 (range $13.58 – $41.66)

Most-billed visit code 99204

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

90.38/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.76

Promoting Interoperability

100

Improvement Activities

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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 Rick Gaines's NPI number?

The NPI number for Rick Gaines is 1437544400. It was assigned to this individual provider in the NPPES registry on April 6, 2015.

Where is Rick Gaines located?

Rick Gaines practices at 8240 Northcreek Dr Ste 4300, Cincinnati, OH 45236. The listed phone number is (513) 246-2400.

What is Rick Gaines's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

Is Rick Gaines enrolled in Medicare?

Yes. Rick Gaines 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.

What insurance does Rick Gaines accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource and Oscar Health Insurance list Rick Gaines as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Rick Gaines affiliated with any hospitals?

According to CMS data, Rick Gaines is affiliated with Mccullough-Hyde Memorial Hospital, Good Samaritan Hospital, Bethesda North and Highland District Hospital.

When was this NPI record last updated?

The NPPES record for Rick Gaines was last updated on August 19, 2021. 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.