Active NPI
Richard B Krzyzak, OD
- Optometrist
- Liverpool, NY
National Provider Identifier
1013903632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- VUT004146
- Practice address
- 4871 W Taft Rd
Liverpool, NY 13088-4819 - Phone
- (315) 451-4600
- Fax
- (315) 451-7710
- NPI assigned
- Sep 20, 2005
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | VUT004146 | NY | Primary |
Addresses
Primary practice location
4871 W Taft Rd
Liverpool, NY 13088-4819
Mailing address
4871 W Taft Rd
Liverpool, NY 13088-4819
Phone (315) 451-4600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00763433 | Medicaid | NY |
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pennsylvania College of Optometry, 1982
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4871 W Taft Rd
Liverpool, NY 13088-4819
Phone (315) 451-4600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VUT004146 | NY | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| K.M. Enterprises, Inc. | Optometrist | Current | Accepting new patients |
Locations
4871 W Taft Rd
Liverpool, NY 13088
Phone (315) 451-4600
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127174400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1013903632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4871 W TAFT RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130884819",
"telephone_number": "315-451-4600",
"fax_number": "315-451-7710"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4871 W TAFT RD",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130884819",
"telephone_number": "315-451-4600",
"fax_number": "315-451-7710"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KRZYZAK",
"first_name": "RICHARD",
"middle_name": "B",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-20",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NY",
"license": "VUT004146",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00763433",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liverpool, 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.