Individual provider Active NPI

Richard B Krzyzak, OD

  • Optometrist
  • Liverpool, NY
National Provider Identifier
1013903632
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
VUT004146 Issued in NY
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

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00763433MedicaidNY

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040623000544 NY Practitioner - Optometry 1153305412 Reassigns benefits to 1 organization

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
K.M. Enterprises IncGroup PAC ID 8527042886, 4 clinicians

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

LicenseStateTypeSpecialty
VUT004146NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
K.M. Enterprises, Inc. Optometrist CurrentSince Jul 1, 2004 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

Verify at the official NPI Registry.