ETHAN DAVID ROYSTER – Optometrist, NPI 1417479684

ETHAN DAVID ROYSTER is a healthcare provider. based in Wylie, Texas. specializing in OPTOMETRY. They hold a License No. 9239T (TX). The NPI Number for ETHAN DAVID ROYSTER is 1417479684

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
ETHAN DAVID ROYSTER
NPI
1417479684
Phone
1 (972) 429-9090
Address
130 N BALLARD AVE
Enumeration Date
10 July 2017
Last Update Date
10 July 2017

Doctor Profile

Medical School Name
UNIVERSITY OF HOUSTON - COLLEGE OF OPTOMETRY
Secondary Phone
9724299011
Graduation Year
2017 (9 years ago)
PAC ID
3577825579
Group Practice PAC ID
1355684754
Professional Enrollment ID
I20180402000611
Address ID
TX750943551MU213XXRDXX401
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

3,129 OPTOMETRY in TX

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Provider Addresses for ETHAN DAVID ROYSTER

  • 130, North Ballard Avenue, Wylie, Collin County, Texas, 75098, United States

    WYLIE, TX 750984467

    Phone: 1 (972) 429-9090

    Fax: (972) 429-7676

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $198.

Total Amount is formed as General ($198) + Research ($0) + Ownership ($0) = $198.

Last reported payment date: 2024-07-25 • Largest payer in this snapshot: Bausch & Lomb Americas Inc. ($146).

Total Amount

$198

General + Research + Ownership

Payments

6

Total payment records

General Amount

$198

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-25

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-04-02

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180402000611IOptometryTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
92250Photography of the retina7164$0
92014Established patient complete exam of visual system6969$0
92012Established patient problem focused exam of visual system5141$0
92004New patient complete exam of visual system2424$0
92083Exam of visual field with extended testing1814$0
View full utilization report →

Insurance plans in this area (ZIP 75098)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355684754View full group profile
NameSpecialtyState
O P T O M E T R YTX
O P T O M E T R YTX
O P T O M E T R YTX
O P T O M E T R YTX
O P T O M E T R YTX

Reviews

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Frequently asked questions

Can I cross-check ETHAN DAVID ROYSTER using NPI 1417479684?
NPI 1417479684 belongs to ETHAN DAVID ROYSTER; compare other details if you need extra assurance.
Is ETHAN DAVID ROYSTER still an active registrant?
ETHAN DAVID ROYSTER carries an active NPI according to the public dataset.
How would a patient describe ETHAN DAVID ROYSTER's focus?
For ETHAN DAVID ROYSTER, the primary taxonomy reads as Optometrist. Clinical services aligned with this taxonomy classification.
What locale is associated with ETHAN DAVID ROYSTER?
Directory geography for ETHAN DAVID ROYSTER centers on Wylie, Texas.
Can I trust this NPI listing for ETHAN DAVID ROYSTER?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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