Individual provider Active NPI

Michael Timothy Kryshtalskyj, M.D.

  • Ophthalmology Physician
  • Wayne, PA
National Provider Identifier
1720972334
Registry record updated Nov 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
MD489386 Issued in PA
Practice address
123 Bloomingdale Ave.
Suite 102
Wayne, PA 19087
Phone
(610) 687-8771
Fax
(610) 687-8773
NPI assigned
Jun 6, 2025
Last updated
Nov 26, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X C1-0028100 DE
Ophthalmology Physician 207W00000X 25MA12621700 NJ
Ophthalmology Physician 207W00000X MD489386 PA Primary

Addresses

Primary practice location

123 Bloomingdale Ave.
Suite 102
Wayne, PA 19087

Mailing address

123 Bloomingdale Ave.
Suite 102
Wayne, PA 19087
Phone (647) 938-4450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20251231003683 PA Practitioner - Ophthalmology 6103322086 Reassigns benefits to 2 organizations
I20260317004911 NJ Practitioner - Ophthalmology 6103322086 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Refocus Eye Health of NJ PCGroup PAC ID 2365830668, 46 clinicians

Practice addresses (Care Compare)

123 Bloomingdale Ave
Suite 102
Wayne, PA 19087-4056
Phone (610) 687-8771

3 Cooper PLZ
Camden, NJ 08103-1438
Phone 21528850001225

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C1-0028100DEMDOphthalmology Physician
25MA12621700NJMDOphthalmology Physician
MD489386PAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heron Rock Surgery Center of Lancaster CurrentSince Oct 3, 2025 Accepting new patients
Morgenstern Center for Orbital and Facial Plastic Surgery, Inc. Ophthalmology CurrentSince Oct 3, 2025 Accepting new patients
Morgenstern Center for Orbital and Facial Plastic Surgery of NJ LLC Ophthalmology CurrentSince Feb 23, 2026 Accepting new patients

Locations

1051 W Sherman Ave
Ste 5A
Vineland, NJ 08360
Phone (856) 691-0504

604 Community Way
Lancaster, PA 17603
Phone (610) 687-8771

606 Community Way
Lancaster, PA 17603
Phone (610) 541-2807

123 Bloomingdale Ave
Ste 102
Wayne, PA 19087
Phone (610) 541-2807

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1749168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764115200000",
    "number": "1720972334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 BLOOMINGDALE AVE.",
            "address_2": "SUITE 102",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "19087",
            "telephone_number": "647-938-4450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 BLOOMINGDALE AVE.",
            "address_2": "SUITE 102",
            "city": "WAYNE",
            "state": "PA",
            "postal_code": "19087",
            "telephone_number": "610-687-8771",
            "fax_number": "610-687-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYSHTALSKYJ",
        "first_name": "MICHAEL",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-06",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DE",
            "license": "C1-0028100",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NJ",
            "license": "25MA12621700",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "PA",
            "license": "MD489386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayne, PA

Sources for this page

Verify at the official NPI Registry.