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.
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
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
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)Primary specialty
Medicare Part D claims
MIPS final score
Specialty distribution in Georgia
How Sleep Medicine (Internal Medicine) Physician compares to other specialties among Georgia providers
Sleep Medicine (Internal Medicine) Physician share within Georgia
Sleep Medicine (Internal Medicine) Physician is one of the more visible NUCC categories in Georgia
Each bar reflects the share of in-state providers whose primary NUCC taxonomy matches the specialty. Long tail of ~690 NUCC codes folded into "Other" to keep the comparison legible.
Medicare quality performance — MIPS
RICHARD SIMMONS, MD's 2023 MIPS final score plotted against the Sleep Medicine (Internal Medicine) Physician national average
- 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
Quality benchmarks
- National MIPS avg 2023 reporting year
- Quality dim CMS Quality category
- Specialty volume Sleep Medicine (Internal Medicine) Physician US NPIs
92.9348/100 MIPS final score — 9.8 pts above the 83.1 national average
Quality, Cost, Promoting Interoperability, and Improvement Activities composite score for the 2023 performance year. Specialty: Sleep Medicine (Internal Medicine) Physician. Quality dim: 80.3814.
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
Provider Details
| NPI | 1417942293 |
|---|---|
| Specialty | Sleep Medicine (Internal Medicine) Physician |
| Credentials | MD |
| Gender | Male |
| NPI Issued | 09/16/2005 |
Verify this provider's license
PlainDoctor pulls this profile from the CMS NPPES public registry. Confirm RICHARD SIMMONS, MD's current license status, disciplinary history, and board certifications with the Georgia Composite Medical Board in Georgia before relying on this page for a clinical or care decision.
How we sourced this profile
CMS Quality Score (MIPS)
Merit-based Incentive Payment System (MIPS) scores from CMS, 2023 performance year.
Reporting: Alternative Payment Model
Brand vs generic prescribing mix · Brand-heavy
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.
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
- Trelegy Ellipta
Trelegy Ellipta
308 claims
- Montelukast Sodium
Montelukast Sodium
128 claims
- Albuterol Sulfate … 120
Albuterol Sulfate Hfa
120 claims
- Fluticasone Propio… 64
Fluticasone Propionate
64 claims
- Breo Ellipta 23
Breo Ellipta
23 claims
- Prednisone 20
Prednisone
20 claims
- Famotidine 19
Famotidine
19 claims
- Symbicort 18
Symbicort
18 claims
| 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.
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 →
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Frequently Asked Questions
What is RICHARD SIMMONS, MD's specialty? ▼
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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