Jacob Ettinger, PA
NPI 1063441517 · Surgical Physician Assistant · Great Neck, NY
Enrolled with Medicare as Practitioner - Physician Assistant · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jacob Ettinger, PA is a Surgical Physician Assistant provider in Great Neck, NY (NPI 1063441517).
Provider details
- NPI number
- 1063441517
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 009528 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2006-06-30
- Last updated
- 2025-09-11
Frequently asked questions
- What is Jacob Ettinger's NPI number?
- Jacob Ettinger's National Provider Identifier (NPI) is 1063441517, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Jacob Ettinger's specialty?
- Jacob Ettinger is listed in the NPPES registry with a primary specialty of Surgical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Jacob Ettinger located?
- Jacob Ettinger's practice location on file with NPPES is 21 Canterbury Rd, Great Neck, NY 11021-2123.
- What is Jacob Ettinger's phone number?
- The practice phone number listed in the NPPES registry for Jacob Ettinger is (516) 570-6015.
- Does Jacob Ettinger accept Medicare?
- Jacob Ettinger is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Jacob Ettinger's NPI active?
- Yes — Jacob Ettinger's NPI (1063441517) is active in the NPPES registry as of the last update on 2025-09-11.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.