2026 NPPES data Sleep Medicine (Internal Medicine) Physician NPI 1417942293 MD
Verify on CMS →

RICHARD SIMMONS, MD

Sleep Medicine (Internal Medicine) Physician in LAGRANGE, Georgia. CMS National Plan and Provider Enumeration System profile including specialty classification, practice address, and Medicare prescribing data when reported.

Federal data — no proprietary rating. PlainDoctor publishes the actual CMS NPPES and Medicare records — NPI registration, specialty, practice location, and prescribing data — without a composite score or editorial opinion on top. Every field traces to a federal source.
Prescribing volume
955
Medicare Part D claims · 182 beneficiaries · Sleep Medicine (Internal Medicine) Physician avg: 1K
Generic prescribing
40%
generic claims · 60% brand-name · higher generic rates reduce patient out-of-pocket costs
MIPS score
92.9348/100
▲ 10 pts above national avg 83.1 · [object Object]

What the federal data shows

RICHARD SIMMONS, MD reported a CMS MIPS final score of 92.9348/100 — above the 83.1 national average — and filed 955 Medicare Part D claims in 2023.

92.9348/100
MIPS score · +10 vs avg
955
Part D claims, 2023
40%
generic prescribing
Likely
board-certified (heuristic)

Every figure on this page comes straight from federal CMS records (NPPES, Medicare Part D, MIPS, Open Payments) — no proprietary rating or editorial opinion is applied.

RICHARD SIMMONS, MD's MIPS score vs every scored U.S. clinician

CMS Merit-based Incentive Payment System (MIPS) final score, 2023 — the federal quality measure

93 Top 32% higher than 68% of 477,587 scored providers

0–10: 8,684 scored providers (2%). Below this entry. 10–20: 3,008 scored providers (1%). Below this entry. 20–30: 3,069 scored providers (1%). Below this entry. 30–40: 2,746 scored providers (1%). Below this entry. 40–50: 2,928 scored providers (1%). Below this entry. 50–60: 5,882 scored providers (1%). Below this entry. 60–70: 13,906 scored providers (3%). Below this entry. 70–80: 118,074 scored providers (25%). Below this entry. 80–90: 129,887 scored providers (27%). Below this entry. 90–100: 189,403 scored providers (40%). This entry sits in this band. This provider 0 100 every MIPS-scored clinician, bucketed by value

Each bar is a band; taller bars hold more scored providers. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Merit-based Incentive Payment System (MIPS) · 2023

Board certification likely (heuristic — not verified)

RICHARD SIMMONS, MD practices in an ABMS-board-eligible specialty and shows active CMS Medicare participation + MIPS quality reporting — signals consistent with board-certified status. For verified board certification, see CertificationMatters.org (the official ABMS public lookup).

What does the federal data show about RICHARD SIMMONS, MD?

High performer (top quartile)

NPI registry status

Active

Issued 09/16/2005

NPI 1417942293

Primary specialty

Sleep Medicine (Internal Medicine) Physician

Niche

857 US NPIs in this specialty

Medicare Part D claims

955 27% vs specialty avg

2023 prescription claims

Specialty avg: 1,310

MIPS final score

92.9348/100 9.834800000000001% pts

Exceptional band

vs 83.1 national avg

Specialty distribution in Georgia

How Sleep Medicine (Internal Medicine) Physician compares to other specialties among Georgia providers

Georgia providers

Sleep Medicine (Internal Medicine) Physician share within Georgia

1. Sleep Medicine (Internal Medicine) Physician42%2. Internal medicine21%3. Family medicine17%4. Surgical12%5. Pediatric8%
Sleep Medicine (Internal Medicine) Physician share within Georgia

Medicare quality performance — MIPS

RICHARD SIMMONS, MD's 2023 MIPS final score plotted against the Sleep Medicine (Internal Medicine) Physician national average

High performer (top quartile)
MIPS Final Score
92.9348/100
vs 83.1 national avg · 2023 performance year

MIPS final score (Sleep Medicine (Internal Medicine) Physician) — 92.9348/100 vs national avg 83.1

0%100%National avg83%92.9%
MIPS final score (Sleep Medicine (Internal Medicine) Physician) — 92.9348/100 vs national avg 83.1

The Merit-based Incentive Payment System (MIPS) scores providers 0–100 across four performance categories: Quality, Cost, Promoting Interoperability, and Improvement Activities, weighted under 42 CFR §414.1380. Reporting is voluntary for many small practices, so absence of a MIPS score is not a quality signal.

Board certification through an ABMS or AOA member board signals voluntary post-licensure examination plus continuous Maintenance of Certification cycles. Verify any individual provider's status through certificationmatters.org (ABMS) or osteopathic.org (AOA).

RICHARD SIMMONS, MD appears in the CMS NPPES registry as a Sleep Medicine (Internal Medicine) Physician provider holding MD credentials at 1551 DOCTORS DRIVE, LAGRANGE, GA, 30240, with a listed phone of (706) 884-3389. NPI 1417942293 was issued on 09/16/2005. Because NPPES data is self-reported by the provider and refreshed monthly, the address, phone, and specialty reflect what SIMMONS most recently submitted to CMS rather than a vetted directory listing, which is why patients should always confirm the practice is still at this location before scheduling.

Medicare Part D records for calendar year 2023 show 955 prescription claims written by this provider, covering 182 Medicare beneficiaries and totaling roughly $554K in drug spend, split 60% brand-name and 40% generic by claim count. These figures capture only Medicare Part D — commercial insurance, Medicaid, and cash-pay prescriptions are not included, and any drug-beneficiary cell under 11 is suppressed by CMS for patient privacy. On the CMS Merit-based Incentive Payment System, this provider earned a Final Score of 92.9348/100 for the 2023 performance year (Quality 80.3814), compared with the national average of 83.1.

Sleep Medicine (Internal Medicine) Physician is a narrow specialty nationwide, with 857 enrolled providers across 52 states and an average of 1,310 Part D claims per prescriber, so the context for interpreting these metrics differs meaningfully from a primary-care baseline. Important: PlainDoctor is a directory of publicly available government data, not medical advice, a malpractice database, or a quality rating. Inclusion here does not imply a recommendation, and absence of complaints or sanctions on this page does not mean none exist — always verify credentials through the NPPES NPI Registry, your state medical board, and the ABMS or AOA before making healthcare decisions.

Practice Address

1551 DOCTORS DRIVE
LAGRANGE, GA 30240

Provider Details

NPI 1417942293
Specialty Sleep Medicine (Internal Medicine) Physician
Credentials MD
Gender Male
NPI Issued 09/16/2005

CMS Quality Score (MIPS)

Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.

92.9348
Final Score
Avg: 83.1
80.3814
Quality
100
Promoting Interoperability

Reporting: Alternative Payment Model

Brand vs generic prescribing mix · Brand-heavy

RICHARD SIMMONS, MD — brand share 60.0%
Specialty average (est.)

60% brand-name claims vs 40% generic, on 955 2023 Medicare Part D claims.

The federal Medicare Part D Generic Dispensing Rate national benchmark sits near 90% generic / 10% brand for primary-care prescribers, per CMS Office of the Actuary 2024 estimates. Higher brand share is common in specialty prescribing where generic equivalents are not available.

Medicare Part D Prescribing Data

CMS Medicare Part D prescriber-level data for calendar year 2023.

955
Total Claims
$554K
Total Drug Cost
182
Medicare Beneficiaries

Prescribing Breakdown

30-Day Fills
1,326
Total Day Supply
38,336
Brand vs Generic
60% brand / 40% generic
Brand Drug Cost
$541K
Generic Drug Cost
$13K
Antibiotic Claims
12

Patient Demographics

Average Patient Age
72.8 years
Avg HCC Risk Score
2.08
Gender Split
58% female / 42% male
Age Distribution
<65: 25, 65-74: 77, 75-84: 64, 85+: 16

Top Prescribed Drugs (Medicare Part D)

Top drugs by claim count for calendar year 2023. Based on Medicare Part D data only.

What RICHARD SIMMONS, MD prescribes most

Top Medicare Part D drugs by claim count, 2023

claims
Source CMS Medicare Part D Prescriber Public Use File As of 2023
Drug Claims
Trelegy Ellipta
Fluticasone/Umeclidin/Vilanter
308
Montelukast Sodium
128
Albuterol Sulfate Hfa
Albuterol Sulfate
120
Fluticasone Propionate
64
Breo Ellipta
Fluticasone/Vilanterol
23
Prednisone
20
Famotidine
19
Symbicort
Budesonide/Formoterol Fumarate
18
Ventolin Hfa
Albuterol Sulfate
18
Theophylline Er
Theophylline Anhydrous
15

* Counts below 11 are suppressed by CMS for patient privacy. Generic names shown where available from CMS Part D data.

Sleep Medicine (Internal Medicine) Physician Overview

How RICHARD SIMMONS, MD fits within the Sleep Medicine (Internal Medicine) Physician landscape nationally.

857
Sleep Medicine (Internal Medicine) Physician Providers in US
52
States with Sleep Medicine (Internal Medicine) Physician
1,310
Avg Claims per Provider

RICHARD SIMMONS, MD's 955 claims are below the specialty average of 1,310.

Nearby Sleep Medicine (Internal Medicine) Physician Providers in Georgia

Other clinicians with the same primary specialty enrolled in Georgia, drawn from the same CMS NPPES roster as SIMMONS.

Compare Sleep Medicine (Internal Medicine) Physician nationally: see state-by-state distribution →

Frequently Asked Questions

What is RICHARD SIMMONS, MD's specialty?
RICHARD SIMMONS, MD specializes in Sleep Medicine (Internal Medicine) Physician and practices in LAGRANGE, Georgia. Credentials: MD.
How much does RICHARD SIMMONS, MD prescribe under Medicare Part D?
In 2023, RICHARD SIMMONS, MD wrote 955 Medicare Part D claims totaling $554K in drug costs for 182 beneficiaries.
What is RICHARD SIMMONS, MD's Medicare quality score?
RICHARD SIMMONS, MD has a CMS MIPS Final Score of 92.9348/100 (Quality: 80.3814). The national average MIPS Final Score is 83.1. Source: CMS Merit-based Incentive Payment System (MIPS) 2023.
Where is RICHARD SIMMONS, MD located?
RICHARD SIMMONS, MD is located at 1551 DOCTORS DRIVE, LAGRANGE, GA, 30240. Phone: (706) 884-3389.
What is RICHARD SIMMONS, MD's NPI number?
RICHARD SIMMONS, MD's National Provider Identifier (NPI) is 1417942293, issued on 09/16/2005.
Does RICHARD SIMMONS, MD prescribe more brand-name or generic drugs?
RICHARD SIMMONS, MD's prescribing is 60% brand-name and 40% generic drugs by claim count, with $541K in brand drug costs.
How many Sleep Medicine (Internal Medicine) Physician providers are there in the US?
There are 857 Sleep Medicine (Internal Medicine) Physician providers across 52 states in the US. The average Sleep Medicine (Internal Medicine) Physician provider writes 1,310 Medicare Part D claims per year.
What drugs does RICHARD SIMMONS, MD prescribe most often?
Based on 2023 Medicare Part D data, RICHARD SIMMONS, MD's most frequently prescribed drugs include Trelegy Ellipta, Montelukast Sodium, Albuterol Sulfate Hfa. This reflects Medicare Part D prescriptions only and does not include commercial insurance or other payer types.
Does RICHARD SIMMONS, MD accept Medicare?
RICHARD SIMMONS, MD appears in CMS Medicare data with 955 Part D claims and 182 Medicare beneficiaries in 2023. Contact the provider's office directly to confirm current Medicare enrollment and accepted plans.
How can I verify RICHARD SIMMONS, MD's credentials?
RICHARD SIMMONS, MD's NPI is 1417942293 with credentials MD. You can verify this through the NPPES NPI Registry, check state medical board records, and confirm board certification through the ABMS or AOA.

Data Sources

Provider Directory
CMS National Plan and Provider Enumeration System (NPPES), download.cms.gov/nppes, updated monthly. Contains NPI, specialty, credentials, and practice location.
Specialty Classification
NUCC Health Care Provider Taxonomy (nucc.org), the industry standard for classifying provider specialties in Medicare and Medicaid billing.
Prescribing Data
CMS Medicare Part D Prescriber Public Use File (2023). Includes claims, drug costs, beneficiaries, and opioid prescribing rates.
Quality Performance
CMS Merit-based Incentive Payment System (MIPS) — 2023 performance year.
Limitations
Provider data is self-reported to CMS. Prescribing data reflects Medicare Part D only and does not include commercial insurance, Medicaid, or cash prescriptions. Claims below 11 beneficiaries are suppressed by CMS for privacy.

See our complete data methodology for details on how we collect and process government data.

Data as of April 2026 (NPPES) / 2023 (Medicare Part D). Source: Centers for Medicare & Medicaid Services (CMS).

Disclaimer: Data from CMS NPPES and Medicare Part D. PlainDoctor does not rate or rank providers. Provider information is self-reported and may not be current. Always verify information directly with the provider. About · Methodology