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DR. BOAZ J LISSAUER MD
NPI 1639173123
Ophthalmology in New York, NY

Active since June 13, 2005Opted out of Medicare · through Jan 1, 2027
1036 PARK AVE, SUITE 1C, NEW YORK, NY 10028(212) 717-2150(212) 717-2154 Get Directions Write a Review

NPPES record last updated: June 25, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Boaz J Lissauer Md NPPES

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

DR. BOAZ J LISSAUER MD (NPI 1639173123) is an individual ophthalmology provider in New York, New York, licensed in New York (208452) and active in the NPI registry since June 2005. He has opted out of Medicare through January 1, 2027 and remains eligible to order and refer and is a graduate of George Washington University School Of Medicine (1996).

NPPES Registry Identity

NPI1639173123
Entity TypeIndividualMale
Primary Taxonomy207W00000X
Provider Legal NameDR. BOAZ J LISSAUERCredential: MD
Location Address1036 PARK AVE, SUITE 1CNew York, NY 10028-0971
Mailing Address1036 Park Ave, Suite 1cNew York, NY 10028-0971 · (212) 717-2150 · Fax (212) 717-2154
Phone(212) 717-2150
Fax(212) 717-2154
Sole ProprietorYes
Medical School CMSGeorge Washington University School Of MedicineGraduated 1996
Enumeration DateJune 13, 2005
Last NPPES UpdateJune 25, 2009
✔ NPI 1639173123 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOphthalmologyAllopathic & Osteopathic Physicians
Taxonomy Code207W00000X
Licenses✔ Licensed in NY · 208452✔ Licensed in NJ · 25MA07699200
Definition
An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.
Also ListedSurgery · Plastic and Reconstructive SurgeryTaxonomy 2086S0122X · License 25MA07699200 (NJ), 208452 (NY)
1036 PARK AVE, New York, NY 10028
Open in Google Maps ↗

Other Identifiers 10

Other271252BNY · Division 1181 Magnacare
OtherP2647045Oxford
Other208452NY · Hip
Other7554155Aetna
Medicare UPINH38324
Other1000035875NY · Affnity Health Plan
Other0498250NY · Ghi
Medicare ID-Type Unspecified377A91NY
OtherBL0482B310NY · Blue Cross Blue Shield
OtherBL0482B310NY · Federal Blue Cross Blue S

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Boaz J Lissauer Md has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2017 through January 1, 2027.

Opt-Out Effective DateJanuary 1, 2017
Opt-Out In Effect ThroughJanuary 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10028 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
$150.24 typical visit price
range $65.69 – $198.19
Typical copayment $37.56 (range $16.42 – $49.54)
Most-billed visit code 99204
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
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 2

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

DR. ADAM DEUTSCH MD
Internal Medicine (Cardiovascular Disease)
1036 PARK AVE
NEW YORK, NY 10028
New York County (212) 879-9000
PARK AVENUE CARDIOLOGY PC
Internal Medicine (Cardiovascular Disease)
1036 PARK AVE, SUTIE 1A
NEW YORK, NY 10028
New York County (212) 879-9000

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 Boaz Lissauer's NPI number?

The NPI number for Boaz Lissauer is 1639173123. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Boaz Lissauer located?

Boaz Lissauer practices at 1036 Park Ave Suite 1C, New York, NY 10028. The listed phone number is (212) 717-2150.

What is Boaz Lissauer's specialty?

The primary specialty registered for this NPI is Ophthalmology with taxonomy code 207W00000X.

Is Boaz Lissauer enrolled in Medicare?

No. Boaz Lissauer has opted out of Medicare through January 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Boaz Lissauer was last updated on June 25, 2009. 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.