DR. SANDRA LYNN ETTEMA (M.D., PH.D.) – Otolaryngology Physician, NPI 1760577902
Otolaryngology Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
488 OTOLARYNGOLOGY in IL
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Provider Addresses for DR. SANDRA LYNN ETTEMA (M.D., PH.D.)
PO BOX 19649
SPRINGFIELD, IL 627949649
Phone: (217) 545-8000
Fax: (217) 545-7781
Type: Mailing
PO BOX 372
MATTOON, IL 619380372
Phone:
Type: Mailing
747, North Rutledge Street, Springfield, Sangamon County, Illinois, 62702, United States
5TH FLOOR
SPRINGFIELD, IL 627026700
Phone: (217) 545-8000
Fax: (217) 545-7781
Type: Location
1005 HEALTH CENTER DR STE 201
MATTOON, IL 619384653
Phone: (217) 258-2409
Fax: (217) 258-2323
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 19 Open Payments records for all available years, with a total value of $1,990.
Total Amount is formed as General ($1,990) + Research ($0) + Ownership ($0) = $1,990.
Last reported payment date: 2024-12-11 • Largest payer in this snapshot: Acclarent, Inc ($1,448).
Total Amount
$1,990
General + Research + Ownership
Payments
19
Total payment records
General Amount
$1,990
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Acclarent, Inc | $1,448 |
| AERIN MEDICAL INC. | $231 |
| Phathom Pharmaceuticals, Inc. | $110 |
| Smith+Nephew, Inc. | $101 |
| Regeneron Healthcare Solutions, Inc. | $56 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2007-07-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070723000056 | I | Otolaryngology | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 31575 | Diagnostic exam of voice box using a flexible endoscope | 98 | 70 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 60 | 46 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 56 | 46 | $0 |
| 43195 | Balloon dilation of esophagus using a rigid endoscope, less than 3.0 cm | 14 | 11 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 13 | $0 |
Insurance plans in this area (ZIP 62794)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Internal Medicine | IL | |
| - | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Family Practice | IL | |
| Infectious Disease | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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