RICHARD KENNETH GAINES MD
NPI 1952355497
Orthopaedic Surgery in Daytona Beach, FL

Q: What is Richard Gaines's NPI number?

The NPI number for Richard Gaines is 1952355497. It was assigned to this individual provider in the NPPES registry on May 20, 2006.

Q: What is Richard Gaines's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Richard Gaines was last updated on November 20, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months 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 May 20, 2006PECOS EnrolledAccepts Medicare Assignment

90.01/100

CMS Quality Rating

1865 LPGA BLVD, DAYTONA BEACH, FL 32117(386) 255-4596(386) 258-3561 Get Directions Write a Review

NPPES record last updated: November 20, 2024. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Nov 20, 2024, Aug 9, 2019, Apr 25, 2018 (3 updates tracked since 2018).

On this page

About Richard Kenneth Gaines Md NPPES

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

RICHARD KENNETH GAINES MD (NPI 1952355497) is an individual orthopaedic surgery provider in Daytona Beach, Florida, licensed in Florida (ME60285) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Halifax Health Medical Center, and maintains 5 additional practice locations.

NPPES Registry Identity

NPI1952355497

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameRICHARD KENNETH GAINESCredential: MD

Location Address1865 LPGA BLVDDaytona Beach, FL 32117-7108

Mailing Address1865 Lpga BlvdDaytona Beach, FL 32117-7108 · (386) 255-4596 · Fax (386) 258-3561

Phone(386) 255-4596

Fax(386) 258-3561

Sole ProprietorNo

Medical School CMSUniversity Of Florida College Of MedicineGraduated 1986

Enumeration DateMay 20, 2006

Last NPPES UpdateNovember 20, 20243 updates tracked since enumeration

NPPES CertifiedNovember 20, 2024

✔ NPI 1952355497 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in FL · ME60285

Definition

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.

Also ListedOrthopaedic Surgery · Sports MedicineTaxonomy 207XX0005X · License ME60285 (FL)

1865 LPGA BLVD, Daytona Beach, FL 32117

Open in Google Maps ↗

Secondary Practice Locations 5

Location 11890 Lpga Blvd Ste 240Daytona Beach, FL 32117-7131 · Phone (386) 255-4596 · Fax (386) 258-3561

Location 21165 Dunlawton Ave Ste 102Port Orange, FL 32127-2924 · Phone (386) 255-4596 · Fax (386) 258-3561

Location 317 Old Kings Rd N Ste KPalm Coast, FL 32137-8283 · Phone (386) 255-4596 · Fax (386) 258-3561

Location 41075 Mason AveDaytona Beach, FL 32117-4611 · Phone (386) 255-4596 · Fax (386) 258-3561

Location 51175 Dunlawton Ave Ste 1Port Orange, FL 32127-4741 · Phone (386) 255-4596 · Fax (386) 258-3561

Other Identifiers 1

Medicaid013894900FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), Florida Health Care Plans and more.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

Richard Kenneth Gaines Md 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 ID5890821227

PECOS Enrollment IDI20100831000555

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 16

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.

Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg J7325

Synvisc or Synvisc-One is a treatment involving an injection of a substance called hyaluronan into your joints. This substance, naturally found in the body, helps lubricate and cushion your joints, reducing pain and improving mobility. It's often used for arthritis patients.

1,680 services25 patients

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

1,136 services176 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

387 services210 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

375 services264 patients

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.

304 services249 patients

Hyaluronan or derivative, orthovisc, for intra-articular injection, per dose J7324

Orthovisc is a treatment involving injections of a substance called hyaluronan into your joints. Hyaluronan is a natural substance in your joint fluid that aids in movement and reduces pain. The Orthovisc injections help replenish this substance, relieving joint pain.

188 services41 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

182 services140 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

163 services124 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

137 services137 patients

X-ray of knee, 1-2 views 73560

An X-ray of the knee with 1-2 views is a quick, painless test that produces images of the knee bones. It helps identify fractures, infections, or changes in the knee joint. During the procedure, you'll be asked to stay still while the X-ray machine captures the images.

82 services56 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

78 services62 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

35 services32 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.

32 services32 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

20 services11 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

17 services17 patients

X-ray of pelvis, 1-2 views 72170

An X-ray of the pelvis, 1-2 views, is a quick and painless imaging test. It uses a small amount of radiation to produce images of the lower part of your torso. These images help to detect any abnormalities or injuries in your hip bones and surrounding structures.

13 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Halifax Health Medical Center

Acute Care Hospitals · Daytona Beach, FL

1/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number100017

Location303 N Clyde Morris BlvdDaytona Beach, FL 32114 · Volusia County

Emergency services Birthing friendly

Adventhealth Daytona Beach

Acute Care Hospitals · Daytona Beach, FL

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number100068

Location301 Memorial Medical ParkwayDaytona Beach, FL 32117 · Volusia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32117 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

90.01/100

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

Individually scored

Quality

84.02

Promoting Interoperability

Improvement Activities

Reported Quality Measures

Advance Care Plan

97%1,414 patients4/55-star benchmark: 100%

Closing the Referral Loop: Receipt of Specialist Report

54%824 patients3/55-star benchmark: 87%

Controlling High Blood Pressure

77%507 patients4/55-star benchmark: 91%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

66%82 patients2/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

97%3,772 patients4/55-star benchmark: 100%

e-Prescribing

97%253 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

41%1,336 patients2/55-star benchmark: 100%

Osteoporosis Management in Women Who Had a Fracture

10%69 patients

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

81%2,263 patients4/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

21%3,286 patients2/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 97% · 1,555 patients

Patients screened: 99% · 1,555 patients

84%126 patients4/55-star benchmark: 100%

Provide Patients Electronic Access to Their Health Information

81%818 patients4/55-star benchmark: 100%

Screening for Osteoporosis for Women Aged 65-85 Years of Age

69%674 patients3/55-star benchmark: 98%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

78%157 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 1,411 patients

Patients totalRate: 1% · 1,411 patients

1%1,411 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Knee orthosis, elastic with condylar pads and joints, with or without patellar control, prefabricated, includes fitting and adjustment L1820

DME-Orthotic Devices · category DF011N

3 suppliers24 claims24 services$96.57 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRENT WILKINS PA-C

Physician Assistant