Ethan Boryszak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

TUV006999-1 Issued in NY

Practice address

5683 S Transit Rd
Lockport, NY 14094-5844

Phone

(716) 631-3860

NPI assigned

Jun 11, 2006

Last updated

Oct 16, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allegany Ophthalmology PLLCGroup PAC ID 8628223732, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ethanboryszakdo@alleganyeye.medentdirect.com

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

• Allegany Ophthalmology PLLC

  dba Council Optometric Center

  • Optometrist
  • Olean, NY
  • NPI 1760736946
  Medicare reassignment Care Compare group NPD
• Kenneth G Vandine MDPC

  • Ophthalmology Physician
  • Wellsville, NY
  • NPI 1881783819
  Medicare reassignment NPD
• Allegany Ophthalmology PLLC

  dba Chautauqua Eyecare

  • Optometrist
  • Jamestown, NY
  • NPI 1730714742
  NPD
• Eye Mac Optometrists PC

  dba Insight Eye Care

  • Optometrist
  • Williamsville, NY
  • NPI 1750602991
  NPD (past)

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1124060751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5683 S TRANSIT RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945844",
            "telephone_number": "716-631-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5683 S TRANSIT RD",
            "city": "LOCKPORT",
            "state": "NY",
            "postal_code": "140945844",
            "telephone_number": "716-631-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORYSZAK",
        "first_name": "ETHAN",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-11",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NY",
            "license": "TUV006999-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samantha Bonafede, LMSW
• Susan Lynne Booth
• Sandra Bordonaro, SPEECH THERAPIST
• Sara Borgstede
• Galina Bors
• Debra L Bramson, SLP
• Sarah Brandt-Douglas, LCSW-R
• Mark N Brandy
• Rebecca E Breezee, MS
• Joseph Peter Breloff, D.D.S., M.S.

• Optometrist in Lockport, NY
• Providers in Lockport, NY by specialty
• Optometrist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.