LIGAYA PRYSTOWSKY M.D.
NPI 1821071754
Ophthalmology in Nutley, NJ

Quality Rating: 75 out of 100 score

NPI Status: Active since November 23, 2005

Contact Information

665 FRANKLIN AVE
NUTLEY, NJ
ZIP 07110
Phone: (973) 667-4008
Fax: (973) 667-1655

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Table of Contents

NPI Profile Information
Primary Taxonomy
Insurance Plans Accepted
Medicare Participation & PECOS Status
Areas of Expertise
Physician Visit Costs
Overall Quality Performance
Quality Reporting
Hospital Affiliations - Privileges
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Years of Experience 40
Ophthalmology
Accepts Medicare Approved Payment
PECOS Enrolled
Medicare Quality Reporting

About LIGAYA PRYSTOWSKY

This page provides the complete NPI Profile along with additional information for Ligaya Prystowsky, a provider established in Nutley, New Jersey with a medical specialization in Ophthalmology and more than 40 years of experience. The healthcare provider is registered in the NPI registry with number 1821071754 assigned on November 2005. The practitioner's primary taxonomy code is 207W00000X with license number 25MA04185000 (NJ). The provider is registered as an individual and her NPI record was last updated 18 years ago.

NPI: 1821071754
Provider Name: LIGAYA PRYSTOWSKY M.D.
Gender: Female
Entity Type: Individual
Location Address: 665 FRANKLIN AVE NUTLEY, NJ 07110
Location Phone: (973) 667-4008
Location Fax: (973) 667-1655
Mailing Address: 665 FRANKLIN AVE NUTLEY, NJ 07110
Mailing Phone: (973) 667-4008
Mailing Fax: (973) 667-1655
Medical School Name: OTHER
Graduation Year: 1986
Is Sole Proprietor?: No
Enumeration Date: 11-23-2005
Last Update Date: 10-11-2007
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Ophthalmologists like Ligaya Prystowsky specialize in diagnosing and treating eye conditions. They may perform surgeries to correct vision issues or prevent vision loss due to diseases like glaucoma. Additionally, they can provide eyeglasses, prescribe contact lenses, and offer other vision-related services.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Ophthalmology
Taxonomy Code: 207W00000X
Type: Allopathic & Osteopathic Physicians
License No.: 25MA04185000
License State: NJ
Taxonomy Description: 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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Medicare

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Medicaid

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier	Type / Code	Identifier State
C55374	MEDICARE UPIN (02)	NJ
452776TQ0	MEDICARE PIN (08)	NJ
1582003	MEDICAID (05)	NJ

Medicare Participation & PECOS Enrollment Status

Ligaya Prystowsky is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Ligaya Prystowsky is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

Is the provider registered in PECOS? Yes
PECOS PAC ID: 9739138439
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.
PECOS Enrollment ID: I20050124000107
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.
Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Cataract surgery
Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye
Creation of eye fluid drainage tracts in iris using a laser, per session
Dilation to improve eye fluid flow
Established patient complete exam of visual system
Established patient problem focused exam of visual system
Evaluation of eye adaptation to light and dark
Exam of the internal drainage system of eye
Exam of visual field with extended testing
Extended exam involving color vision testing
Extended exam of the back part of the eye with retinal drawing
Imaging of retina
Incision to improve eye fluid flow
Laser repair to improve eye fluid flow
New patient complete exam of visual system
Photography of content of eyes
Probing of nasal tear duct
Removal of recurring cataract in lens capsule using a laser
Ultrasound scan to determine eye length and lens power
Ultrasound scan to determine eye length and lens power

Physician Visit Costs

The typical physician office visit costs for Medicare beneficiaries in this area are: $36.21 for a new patient copayment and $19.77 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 07110 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99204

Average New Patient Price $144.86
Minimum New Patient Price $63.84
Maximum New Patient Price $190.92

Average New Patient Copayment $36.21
Minimum New Patient Copayment $15.96
Maximum New Patient Copayment $47.73

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

Average Established Patient Price $79.09
Minimum Established Patient Price $20.97
Maximum Established Patient Price $155.92

Average Established Patient Copayment $19.77
Minimum Established Patient Copayment $5.24
Maximum Established Patient Copayment $38.98

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Overall MIPS Quality Performance

The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 75, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.

The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.

Final Score: 75 out of 100

The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
Quality Score: N/A

The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.

There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
Promoting Interoperability Score: N/A

The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.

The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data.
Improvement Activities Score: N/A

The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.

The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Cost Score: N/A

The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.

Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.

Quality Reporting

The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.

Quality Measure	Performance	Number of Patients
Closing the Referral Loop: Receipt of Specialist Report	35%	54
Percentage of patients with referrals, regardless of age, for which the referring provider receives a report from the provider to whom the patient was referred
Diabetes: Eye Exam	82%	136
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
Diabetic Retinopathy: Communication with the Physician Managing Ongoing Diabetes Care	54%	26
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed with documented communication to the physician who manages the ongoing care of the patient with diabetes mellitus regarding the findings of the macular or fundus exam at least once within 12 months
Diabetic Retinopathy: Documentation of Presence or Absence of Macular Edema and Level of Severity of Retinopathy	81%	32
Percentage of patients aged 18 years and older with a diagnosis of diabetic retinopathy who had a dilated macular or fundus exam performed which included documentation of the level of severity of retinopathy and the presence or absence of macular edema during one or more office visits within 12 months
Documentation of Current Medications in the Medical Record	74%	928
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration
e-Prescribing	98%	681
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
Falls: Screening for Future Fall Risk	6%	385
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
Health Information Exchange	28%	260
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for at least one transition of care or referral.
Medication Reconciliation	67%	24
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
Patient-Specific Education	95%	2045
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
Primary Open-Angle Glaucoma (POAG): Optic Nerve Evaluation	98%	250
Percentage of patients aged 18 years and older with a diagnosis of primary open-angle glaucoma (POAG) who have an optic nerve head evaluation during one or more office visits within 12 months
Provide 24/7 Access to MIPS Eligible Clinicians or Groups Who Have Real-Time Access to Patient's Medical Record	Yes	N/A
• Provide 24/7 access to MIPS eligible clinicians, groups, or care teams for advice about urgent and emergent care (e.g., MIPS eligible clinician and care team access to medical record, cross-coverage with access to medical record, or protocol-driven nurse line with access to medical record) that could include one or more of the following: • Expanded hours in evenings and weekends with access to the patient medical record (e.g., coordinate with small practices to provide alternate hour office visits and urgent care); • Use of alternatives to increase access to care team by MIPS eligible clinicians and groups, such as e-visits, phone visits, group visits, home visits and alternate locations (e.g., senior centers and assisted living centers); and/or Provision of same-day or next-day access to a consistent MIPS eligible clinician, group or care team when needed for urgent care or transition management.
Provide Patient Access	54%	2045
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold certain information.
Secure Messaging	0%	2045
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure message sent by the patient (or the patient-authorized representative) during the performance period.
Security Risk Analysis	Yes	N/A
Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process.
Specialized Registry Reporting	Yes	N/A
The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI.
Use of High-Risk Medications in the Elderly	0% "Inverse Quality Measure" This is an inverse quality measure, a lower rate means the provider is rated better.	385
Percentage of patients 65 years of age and older who were ordered high-risk medications. Two rates are submitted. 1) Percentage of patients who were ordered at least one high-risk medication. 2) Percentage of patients who were ordered at least two of the same high-risk medication
Use of QCDR for feedback reports that incorporate population health	Yes	N/A
Use of a QCDR to generate regular feedback reports that summarize local practice patterns and treatment outcomes, including for vulnerable populations.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Ligaya Prystowsky is affiliated with the following medical facilities:

Hospital Name	Address	Phone	Hospital Type	Overall Rating
CLARA MAASS MEDICAL CENTER	ONE CLARA MAASS DRIVE BELLEVILLE, NJ 07109	(973) 450-2000	Acute Care Hospitals

NPI Validation Check Digit Calculation

The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1	8	2	1	0	7	1	7	5	4
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
2	8	4	1	0	7	2	7	10
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 8 + 4 + 1 + 0 + 7 + 2 + 7 + 1 + 0 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 4									4

The NPI number 1821071754 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location

The following 2 providers are registered at the same or nearby location.

NPI	Name / Type	Taxonomy	Address
1962690545	LIGAYA PRYSTOWSKY MD PC Organization	Ophthalmology	665 FRANKLIN AVE NUTLEY, NJ 07110 (973) 667-4008
1720223084	OMEGA MEDICAL GROUP, P.C. Organization	Ophthalmology	665 FRANKLIN AVE NUTLEY, NJ 07110 (973) 667-4008

Frequently Asked Questions

What is Ligaya Prystowsky M.D. NPI number?

The NPI number assigned to this healthcare provider is 1821071754, enumerated in the NPI registry as an "individual" on November 23, 2005

Where is the provider located?

The provider is located at 665 Franklin Ave Nutley, Nj 07110 and the phone number is (973) 667-4008

What is the provider specialty code?

The provider's speciality is Ophthalmology with taxonomy code 207W00000X

How many years of experience does Ligaya Prystowsky M.D. have?

The provider has more than 40 years of experience.

What insurance does Ligaya Prystowsky M.D. accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Is Ligaya Prystowsky M.D. registered in PECOS?

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

How much is a visit to Ligaya Prystowsky M.D.?

Medicare beneficiaries should expect a typical cost of $144.86 with an average copayment of $36.21 for new patient appointments. Established patients should expect a typical charge of $79.09 and an average copayment of 19.77. Please review your insurance plan or contact the provider directly to determine your specific costs.

What are some of the services provided by Ligaya Prystowsky M.D.?

The most common procedures or services performed by this practitioner are: Cataract surgery, Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye, Creation of eye fluid drainage tracts in iris using a laser, per session, Dilation to improve eye fluid flow, Established patient complete exam of visual system, Established patient problem focused exam of visual system, Evaluation of eye adaptation to light and dark, Exam of the internal drainage system of eye, Exam of visual field with extended testing, Extended exam involving color vision testing, Extended exam of the back part of the eye with retinal drawing, Imaging of retina, Incision to improve eye fluid flow, Laser repair to improve eye fluid flow, New patient complete exam of visual system, Photography of content of eyes, Probing of nasal tear duct, Removal of recurring cataract in lens capsule using a laser, Ultrasound scan to determine eye length and lens power and Ultrasound scan to determine eye length and lens power.

Is Ligaya Prystowsky M.D. affiliated to any hospitals?

The practitioner is affiliated to the following hospital(s): CLARA MAASS MEDICAL CENTER. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

How do I update my NPI information?

This NPI record was last updated on November 23, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.

About LIGAYA PRYSTOWSKY

Location Map

Specialty - Primary Taxonomy

Ophthalmology

Insurance Plans Accepted

Additional Identifiers

Medicare Participation & PECOS Enrollment Status

Is the provider registered in PECOS? Yes

PECOS PAC ID: 9739138439

PECOS Enrollment ID: I20050124000107

Accepts Medicare Assignment? Yes

Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

Eligible to Order or Refer a Home Health Agency (HHA): Yes

Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

Cataract surgery

Complex extracapsular removal of cataract with insertion of artificial lens and insertion of drainage device in front chamber of eye

Creation of eye fluid drainage tracts in iris using a laser, per session

Dilation to improve eye fluid flow

Established patient complete exam of visual system

Established patient problem focused exam of visual system

Evaluation of eye adaptation to light and dark

Exam of the internal drainage system of eye

Exam of visual field with extended testing

Extended exam involving color vision testing

Extended exam of the back part of the eye with retinal drawing

Imaging of retina

Incision to improve eye fluid flow

Laser repair to improve eye fluid flow

New patient complete exam of visual system

Photography of content of eyes

Probing of nasal tear duct

Removal of recurring cataract in lens capsule using a laser

Ultrasound scan to determine eye length and lens power

Ultrasound scan to determine eye length and lens power

Physician Visit Costs

New Patients Visit Costs *

Established Patients Visit Costs *

Overall MIPS Quality Performance

Final Score: 75 out of 100

Quality Score: N/A

Promoting Interoperability Score: N/A

Improvement Activities Score: N/A

Cost Score: N/A