Doctor Profile
James E. Simmons
Providence, RI 02903
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💳 Check Plan Coverage 📞 Call Office 🗺️ Get Directions 🏛️ Verify on Medicare.govReviewed by: Wes Ward, Founder & Data Lead • View our methodology
Important: We are not affiliated with Medicare, CMS, or James E. Simmons's practice. This page displays publicly available CMS data to help you research Medicare providers. We do not sell insurance or represent any insurance company. For official enrollment and complete plan information, visit Medicare.gov or call 1-800-MEDICARE.
Medicare Plans That Cover Dr. Simmons
See which plans Dr. Simmons accepts
We're pulling plan acceptance data directly from insurance carrier provider directories. Until that feed is live for Rhode Island, the fastest way to find a Medicare plan that covers Dr. Simmons is to compare every Medicare Advantage and Part D plan available near 02903, RI — the Pulmonary Disease's office can quickly confirm which of the top local plans they accept.
Compare Medicare Plans near 02903, RI →Or call the office at (401) 444-4741 to confirm acceptance directly.
What Dr. Simmons Does
Dr. Simmons served 261 Medicare patients across 361 services in the latest CMS reporting year. That's 38% below the average Pulmonary Disease in Rhode Island (420 patients across 35 doctors).
| Procedure | Services | Medicare Patients |
|---|---|---|
| Critical care, first 30-74 minutes (99291) | 180 | 89 |
| Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes (99233) | 42 | 33 |
| Test to examine how well the lungs exchange gases (94729) | 31 | 31 |
| Test to determine lung volumes using sensors (94726) | 23 | 23 |
| Test for exercise-induced lung stress (94618) | 19 | 19 |
How to read this: "Services" are the total times Dr. Simmons billed Medicare for each procedure in the latest reporting year. "Patients" counts unique Medicare beneficiaries. Procedures are shown in plain English; the underlying HCPCS codes are available on request.
Hospital Affiliations
Dr. Simmons is affiliated with 2 hospitals according to CMS Physician Compare. Below are the 2 hospitals with full quality profiles on our site. Hospital network status depends on your Medicare Advantage plan — always verify before enrolling.
The Miriam Hospital
Rhode Island Hospital
Practice Location & Telehealth Readiness
Dr. Simmons practices at the address below. If you're evaluating Medicare coverage, location matters for in-network access and — when Dr. Simmons offers telehealth — broadband availability at your home matters for virtual visits.
Address: 593 EDDY ST, Providence, RI 02903
Phone: (401) 444-4741
Practice Accessibility
Average commute time in this zip · 56% of residents drive to work. Practical context for patients deciding whether to make the trip. See the full neighborhood profile at BestNeighborhood.org.
Telehealth Readiness
Households with fiber broadband — important for reliable virtual visits. Check your address at ISPReports.org.
Other Pulmonology Doctors near 02903, RI
If Dr. Simmons isn't accepting new patients or isn't in your plan's network, these are the closest pulmonology doctors near 02903, RI:
| Doctor | Specialty | Medicare Patients / yr | Distance |
|---|---|---|---|
| Nicholas S. Ward | Pulmonary Disease | 281 | <1 mi |
| Vesna Buntak | Pulmonary Disease | 20 | <1 mi |
| Peter Karczmar | Pulmonary Disease | 537 | <1 mi |
| Debasree Banerjee | Pulmonary Disease | 234 | <1 mi |
| Samuel K. Evans | Pulmonary Disease | 577 | <1 mi |
How to Use This Information
Choosing a Medicare plan that covers Dr. Simmons takes three steps:
- Verify network status. Medicare Advantage plans each have their own provider networks. The same doctor may be in-network for one plan and out-of-network for another. Compare all Medicare plans near 02903, RI →
- Confirm directly with the office. Call Dr. Simmons's office at (401) 444-4741 to verify they're accepting new patients and which plans they currently accept. Use our printable question list →
- Check enrollment windows. You can only switch Medicare plans during specific periods. Missing a deadline can cost you a year of coverage. Review enrollment dates →
James E. Simmons: Common Questions
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About the Reviewer
Wes Ward
Founder & Data Lead
Wes Ward reviews all doctor profiles and methodology for data accuracy. Every Medicare provider page on this site — including the utilization statistics, hospital affiliations, and geocoded practice address — goes through his data-validation pipeline before publication. We display only publicly available CMS data; you never need to enter personal information to see any of it.
With 25+ years in data analytics — including work with highly regulated genomic data at Ancestry.com — Wes brings enterprise-level rigor to healthcare transparency. He is also a co-founder of BestNeighborhood.org (neighborhood data), CrimeGrade.org (block-level safety analytics), and ISPReports.org (broadband availability for telehealth). Those sister sites power the location and telehealth-readiness context on this page.
View full profile → • LinkedIn
Data sources: CMS NPPES (2026), CMS Medicare Provider Utilization & Payment Data (2023), CMS Physician Compare, CrimeGrade.org, BestNeighborhood.org, ISPReports.org. This page is for informational purposes only. Always verify coverage directly with the plan and practice. Read our full methodology → • Privacy policy
Medicare Resources
Choosing the right Medicare plan involves more than just doctor coverage. These guides help you evaluate the full picture:
How to Choose a Medicare Plan
In-depth guide to plan types, Star Ratings, drug tiers, and costs.
Enrollment Checklist
Printable step-by-step guide to gather your info and enroll.
Enrollment Dates & Deadlines
Key periods, timelines, and penalty calculations.
Questions for Your Doctor
Printable list to discuss Medicare with Dr. Simmons or any physician.
Medicare Glossary
Definitions for 40+ complex Medicare terms.
Our Methodology
Learn how we source and verify CMS data for accuracy.