Active NPI
Richard G Etra, M.D.
- Otolaryngology Physician
- Great Neck, NY
National Provider Identifier
1679558118
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 128003
- Practice address
- 560 Northern Blvd
Great Neck, NY 11021-5100 - Phone
- (516) 487-6200
- Fax
- (516) 487-6329
- NPI assigned
- Dec 7, 2005
- Last updated
- Jul 13, 2026
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 128003 | NY | Primary |
Addresses
Primary practice location
560 Northern Blvd
Great Neck, NY 11021-5100
Mailing address
175 Jericho Tpke
Syosset, NY 11791-4532
Phone (516) 622-6000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- Tufts University School of Medicine, 1975
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
560 Northern Blvd
Suite 104
Great Neck, NY 11021-5100
Phone (516) 487-6200
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.58 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 78.61
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Allergy & Immunology Physician
- Brooklyn, NY
- NPI 1700312774
-
- Otolaryngology Physician
- Great Neck, NY
- NPI 1457432304
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1679558118",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "175 JERICHO TPKE",
"city": "SYOSSET",
"state": "NY",
"postal_code": "117914532",
"telephone_number": "516-622-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "560 NORTHERN BLVD",
"city": "GREAT NECK",
"state": "NY",
"postal_code": "110215100",
"telephone_number": "516-487-6200",
"fax_number": "516-487-6329"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ETRA",
"first_name": "RICHARD",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "NY",
"license": "128003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Great Neck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.