DR. SANDRA LYNN ETTEMA M.D., PH.D.
NPI 1760577902
Otolaryngology in Mattoon, IL

Q: What is Sandra Ettema's NPI number?

The NPI number for Sandra Ettema is 1760577902. It was assigned to this individual provider in the NPPES registry on October 4, 2006.

Q: What is Sandra Ettema's specialty?

The primary specialty registered for this NPI is Otolaryngology with taxonomy code 207Y00000X.

Q: When was this NPI record last updated?

The NPPES record for Sandra Ettema was last updated on November 8, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 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 October 04, 2006PECOS EnrolledAccepts Medicare Assignment

91.8/100

CMS Quality Rating

1005 HEALTH CENTER DR STE 201, MATTOON, IL 61938(217) 258-2409(217) 258-2323 Get Directions Write a Review

NPPES record last updated: November 8, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Nov 8, 2024, Dec 4, 2023, Nov 3, 2023 and 1 more (4 updates tracked since 2020).

On this page

About Dr. Sandra Lynn Ettema M.d., Ph.d. NPPES

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

DR. SANDRA LYNN ETTEMA M.D., PH.D. (NPI 1760577902) is an individual otolaryngology provider in Mattoon, Illinois, licensed in Illinois (036.118460) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2002).

NPPES Registry Identity

NPI1760577902

Entity TypeIndividualFemale

Primary Taxonomy207Y00000X

Provider Legal NameDR. SANDRA LYNN ETTEMACredential: M.D., PH.D.

Location Address1005 HEALTH CENTER DR STE 201Mattoon, IL 61938-4653

Mailing AddressPo Box 372Mattoon, IL 61938-0372

Phone(217) 258-2409

Fax(217) 258-2323

Sole ProprietorNo

Medical School CMSUniversity Of Illinois College Of Med (chi/peor/rock/chm-urb)Graduated 2002

Enumeration DateOctober 4, 2006

Last NPPES UpdateNovember 8, 20244 updates tracked since enumeration

NPPES CertifiedNovember 8, 2024

✔ NPI 1760577902 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOtolaryngologyAllopathic & Osteopathic Physicians

Taxonomy Code207Y00000X

License✔ Licensed in IL · 036.118460

Definition

An otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise.

1005 HEALTH CENTER DR STE 201, Mattoon, IL 61938

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Other Identifiers 1

Medicaid036118460IL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sandra Lynn Ettema M.d., Ph.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 ID5193826071

PECOS Enrollment IDI20070723000056

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.

Medicare Billing Reassignments

Medicare enrollment records show Sandra Ettema reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Sarah Bush Lincoln Health Center

0.1 mi

Family Medicine

1000 HEALTH CENTER DR
Mattoon, IL 61938

Reassigned Medicare billing, Illinois enrollment
652 clinicians in this Medicare group

NPI 1568581379 (217) 258-2525

Siu Physicians & Surgeons, Inc

77 mi

Endocrinology, Diabetes & Metabolism

201 E MADISON ST STE 328
Springfield, IL 62702

Reassigned Medicare billing, Illinois enrollment
645 clinicians in this Medicare group

NPI 1558385989 (217) 545-8000

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 8

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 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.

121 services92 patients

Diagnostic exam of voice box using a flexible endoscope 31575

This procedure involves a doctor examining your voice box using a flexible endoscope, a thin tube with a light and camera. It's inserted through your nose or mouth to visualize your throat area. It helps detect any abnormalities in your voice box, ensuring optimal vocal health.

118 services91 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.

53 services53 patients

Prolonged office or other outpatient evaluation and management service(s) beyond the maximum required time of the primary procedure which has been selected using total time on the date of the primary service; each additional 15 minutes by the physician or G2212

This service refers to extended doctor visits where your healthcare provider spends additional time evaluating and managing your health beyond the primary procedure's required time. This includes each extra 15 minutes spent by the physician on the same day as the primary service.

51 services31 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.

28 services24 patients

Balloon dilation of esophagus using a rigid endoscope, less than 3.0 cm 43195

This procedure involves a doctor using a rigid tube with a camera (endoscope) to view your esophagus. A small balloon attached to the endoscope is then inflated to stretch a narrow part of the esophagus. It's used to treat difficulty in swallowing.

18 services12 patients

Hospital Affiliations CMS Care Compare 2

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

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140032

Location503 N Maple StreetEffingham, IL 62401 · Effingham County

Emergency services Birthing friendly

Sarah Bush Lincoln Health Center

Acute Care Hospitals · Mattoon, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140189

Location1000 Health Center Drive P O Box 372Mattoon, IL 61938 · Coles County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61938 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

$127.46 typical visit price

range $54.80 – $168.44

Typical copayment $31.86 (range $13.70 – $42.11)

Most-billed visit code 99204

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

91.8/100

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

Scored through an Alternative Payment Model

Quality

75.59

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 9

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

LORI CUDONE M.D.

Otolaryngology