Ethan David Royster

Primary specialty

OptometristTaxonomy code 152W00000X

License

9239T Issued in TX

Practice address

130 N Ballard Ave
Wylie, TX 75098-4467

Phone

19724299090

Fax

(972) 429-7676

NPI assigned

Jul 10, 2017

Sex

Male

Sole proprietor

No

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 TX

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

University of Houston - College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beth Digby Anderson, O.D., PLLCGroup PAC ID 1759422629, 6 clinicians

Eye Center of Murphy PLLCGroup PAC ID 1355684754, 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Beth Digby Anderson, O.D., PLLC

  • Optometrist
  • Wylie, TX
  • NPI 1225367733
  Medicare reassignment Care Compare group NPD
• Eye Center of Murphy PLLC

  • Optometrist
  • Murphy, TX
  • NPI 1154882355
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1499644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1499644800000",
    "number": "1417479684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N BALLARD AVE",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984467",
            "telephone_number": "19724299090",
            "fax_number": "972-429-7676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N BALLARD AVE",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750984467",
            "telephone_number": "19724299090",
            "fax_number": "972-429-7676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROYSTER",
        "first_name": "ETHAN",
        "middle_name": "DAVID",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-10",
        "last_updated": "2017-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "9239T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Nicole Roesch, DPT
• Daphne Rogers- Beckley, APRN
• Catherine Elizabeth Rossio, MS, LPC
• Burnett Lee Rossum
• Rowlett Cardiology Associates PA
• Joanna Rubenfield
• Ruby Home Health Care LLC
• Courtney L Ruetz, LMFT
• Russell Dialysis LLC
• Ruth Home Health Care LLC

• Optometrist in Wylie, TX
• Providers in Wylie, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2017; 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.