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ETHAN BORYSZAK O.D.
NPI 1124060751
Optometrist in Lockport, NY

Active since June 11, 2006PECOS EnrolledAccepts Medicare Assignment
5683 S TRANSIT RD, LOCKPORT, NY 14094(716) 631-3860 Get Directions Write a Review

NPPES record last updated: October 16, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ethan Boryszak O.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN BORYSZAK O.D. (NPI 1124060751) is an individual optometrist in Lockport, New York, licensed in New York (TUV006999-1) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS and is a graduate of Other (2005).

NPPES Registry Identity

NPI1124060751
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameETHAN BORYSZAKCredential: O.D.
Location Address5683 S TRANSIT RDLockport, NY 14094-5844
Mailing Address5683 S Transit RdLockport, NY 14094-5844 · (716) 631-3860
Phone(716) 631-3860
Sole ProprietorYes
Medical School CMSOtherGraduated 2005
Enumeration DateJune 11, 2006
Last NPPES UpdateOctober 16, 2008
✔ NPI 1124060751 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in NY · TUV006999-1
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
5683 S TRANSIT RD, Lockport, NY 14094
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Other Identifiers 3

OtherNY6999NY · Eye Med
Medicaid02748149NY
Other1124060751NY · Univera

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Ethan Boryszak O.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830480201
PECOS Enrollment IDI20221201001969
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient problem focused exam of visual system 92012
This is a routine check-up for existing patients focusing on the visual system. It involves examining your eyes to detect any potential issues or changes in your vision. It's a crucial part of maintaining good eye health.
22 services21 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14094 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$126.40 typical visit price
range $54.87 – $166.88
Typical copayment $31.60 (range $13.71 – $41.72)
Most-billed visit code 99204
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

LICATA OPTICAL CO. INC.
Optometrist
5683 S TRANSIT RD
LOCKPORT, NY 14094
Niagara County (716) 433-1844

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Boryszak's NPI number?

The NPI number for Ethan Boryszak is 1124060751. It was assigned to this individual provider in the NPPES registry on June 11, 2006.

Where is Ethan Boryszak located?

Ethan Boryszak practices at 5683 S Transit Rd, Lockport, NY 14094. The listed phone number is (716) 631-3860.

What is Ethan Boryszak's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Ethan Boryszak enrolled in Medicare?

Yes. Ethan Boryszak is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Ethan Boryszak accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 1 other insurer list Ethan Boryszak as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Ethan Boryszak was last updated on October 16, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.