Sandra Lynn Ettema, M.D., PH.D.

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

036.118460 Issued in IL

Practice address

1005 Health Center Dr Ste 201
Mattoon, IL 61938-4653

Phone

(217) 258-2409

Fax

(217) 258-2323

NPI assigned

Oct 4, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Otolaryngology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sarah Bush Lincoln Health CenterGroup PAC ID 5092614867, 411 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Sarah Bush Lincoln Health Center Hospital, Mattoon, IL, CCN 140189
• St Anthonys Memorial Hospital Hospital, Effingham, IL, CCN 140032

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as group

Merit-based Incentive Payment System (MIPS)

Final score

88.96 of 100Reported as apm

Quality

69.5

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

91.05 of 100Reported as apm

Quality

72.1

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Medicare reassignment Care Compare group NPD
• Siu Physicians & Surgeons, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989
  Medicare reassignment NPD
• Sarah Bush Lincoln Health Center

  • Rural Health Clinic/Center
  • Greenville, IL
  • NPI 1811858970
  NPD
• Siu Physicians & Surgeons, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, IL
  • NPI 1164055976
  NPD
• Knox Clinic Corp

  • Durable Medical Equipment & Medical Supplies
  • Galesburg, IL
  • NPI 1669947503
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sarah Bush Lincoln Health Center

  • General Acute Care Hospital
  • Mattoon, IL
  • NPI 1669564662
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • General Acute Care Hospital
  • Effingham, IL
  • NPI 1306800602
  Care Compare affiliation
• St Anthonys Memorial Hospital of the Hospital Sisters of the Third

  • Clinic/Center
  • Effingham, IL
  • NPI 1881214104

  Hospital

  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1760577902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619380372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DR STE 201",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384653",
            "telephone_number": "217-258-2409",
            "fax_number": "217-258-2323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTEMA",
        "first_name": "SANDRA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-04",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "IL",
            "license": "036.118460",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036118460",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sandraettema@siusm.allscriptsdirect.net",
            "affiliation": "N",
            "address_1": "747 N Rutledge St",
            "address_2": "5TH FLOOR",
            "city": "Springfield",
            "state": "IL",
            "country_code": "US",
            "postal_code": "627026700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Madison Emmerich, RSA
• Jackie England
• Karie Erickson
• Alesha Esker, OTR/L
• Barbara E Estes, M.S.
• Jessica Marie Evans, BS
• Amy Nicole Evermon, M.S.ED
• Julie Evilsizer, PTA
• Family Home Care, Inc.
• Kathleen Farrell, BA

• Otolaryngology Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Otolaryngology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.

Verify at the official NPI Registry.