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Active NPI 1124060751 Individual Practitioner Male Practitioner

Dr. Ethan Boryszak , OD

Optometrist • Lockport, NY

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Boryszak, OD is a certified Optometrist practicing in Lockport, NY. With approximately 21 years of clinical experience since completing medical education in 2005, Dr. Boryszak delivers high-quality medical care to the local community at 5683 S TRANSIT RD.

Dr. Boryszak is affiliated with Allegany Ophthalmology Pllc and accepts Medicare assignment.

Frequently performed procedures and clinical services include established patient problem focused exam of visual system. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5683 S Transit Rd

Lockport, NY 140945844

Telephone 7166313860
Associated Practice Facility / Clinic
🏢 Licata Optical Co. Inc. Facility NPI 1629088273

Medicare Profile & Education

Medical School

Other

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Optometrist in Lockport, NY

Senior Veteran Specialist (>20 Yrs)
Practitioner Clinical Experience
21 Yrs -4.0 yrs vs City Avg
City Avg: 25.0 Yrs
State Avg: 23.8 Yrs
Regional Practice Density
7 Specialists

Practicing in Lockport, NY (3674 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
1.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Boryszak (21 Years) 21 Yrs
Lockport Specialty Average (25.0 Years) 25.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
92012 Established patient problem focused exam of visual system
22 21 $85.47 $84.41

Medical Specialties & State Licenses

Optometrist Primary Specialty

NUCC Taxonomy Code: 152W00000X

State License NY TUV006999-1

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
02748149 (NY)
Commercial Insurance / Payer ID Univera
1124060751 (NY)
Commercial Insurance / Payer ID Eye Med
NY6999 (NY)

Hospital & Practice Group Affiliations

Allegany Ophthalmology Pllc

168 N Union St, Olean, NY 147602735

Phone: 7163729464

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

3 Associated Practitioners
Christina Golab

Optometrist

NPI 1194498543
NPI 1235134313

Doctor of Optometry

David Licata

Technician/Technologist - Optician

NPI 1922136464

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 16, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location October 16, 2008

Registered at 5683 S TRANSIT RD, LOCKPORT, NY 140945844 (Tel: 7166313860)

📍
Updated Business Mailing Address October 16, 2008

Registered at 5683 S TRANSIT RD, LOCKPORT, NY 140945844 (Tel: 7166313860)

👤
Provider Name / Credentials Updated October 16, 2008

Recorded as ETHAN BORYSZAK, O.D.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 16, 2008

Optometrist (License #TUV006999-1 in NY)

🟢
Initial NPI Registration & Enumeration June 11, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1124060751
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 11, 2006
Last Update: October 16, 2008
Sole Proprietor: Yes

Mailing Address

5683 S Transit Rd

Lockport, NY 140945844

Phone: 7166313860

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.