Ethan Boryszak, OD - Medicare Optometrist in Lockport, NY

Ethan Boryszak, OD is a medicare enrolled "Optometrist" provider in Lockport, New York. His current practice location is 5683 S Transit Rd, Lockport, New York. You can reach out to his office (for appointments etc.) via phone at (716) 631-3860.

Ethan Boryszak is licensed to practice in New York (license number TUV006999-1) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124060751.

Contact Information

Ethan Boryszak, OD
5683 S Transit Rd,
Lockport, NY 14094-5844
(716) 631-3860
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameEthan Boryszak
GenderMale
SpecialityOptometrist
Location5683 S Transit Rd, Lockport, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124060751
  • Provider Enumeration Date: 06/11/2006
  • Last Update Date: 10/16/2008
  Medicare PECOS Information:
  • PECOS PAC ID: 9830480201
  • Enrollment ID: I20221201001969

Medical Identifiers

Medical identifiers for Ethan Boryszak such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124060751NPI-NPPES
1124060751OtherNYUNIVERA
NY6999OtherNYEYE MED
02748149MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist TUV006999-1 (New York)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ethan Boryszak allows following entities to bill medicare on his behalf.
Provider NameKenneth G Vandine Mdpc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1881783819
PECOS PAC ID: 5698865996
Enrollment ID: O20071226000015
Provider NameAllegany Ophthalmology Pllc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1760736946
PECOS PAC ID: 8628223732
Enrollment ID: O20130221000049

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Boryszak is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ethan Boryszak, OD
5683 S Transit Rd,
Lockport, NY 14094-5844

Ph: (716) 631-3860
Ethan Boryszak, OD
5683 S Transit Rd,
Lockport, NY 14094-5844

Ph: (716) 631-3860

Reviews and Comments


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Practice Location: 500 Davison Rd, Lockport, NY 14094
Phone: 716-434-8063    Fax: 716-434-2845

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.