Individual provider Active NPI

Gregory A Kiracofe, O.D.

  • Optometrist
  • Dayton, OH
National Provider Identifier
1184688384
Registry record updated May 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3543 T313 Issued in OH
Practice address
617 Shroyer Road
Dayton, OH 45419-4055
Phone
(937) 461-1111
Fax
(937) 224-4298
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3543 T313 OH Primary

Addresses

Primary practice location

617 Shroyer Road
Dayton, OH 45419-4055

Mailing address

617 Shroyer Road
Dayton, OH 45419-4055
Phone (937) 461-1111

Other identifiers 1

IdentifierTypeStateIssuer
0979213MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119000037 OH Practitioner - Optometry 7214841683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dayton Glaucoma and Cataract Consultants IncGroup PAC ID 3971914433, 2 clinicians

Practice addresses (Care Compare)

1222 S Patterson Blvd
Suite 300
Dayton, OH 45402-2643
Phone (937) 461-1111

Merit-based Incentive Payment System (MIPS)

Final score
88.69 of 100Reported as group
Quality
100
Improvement activities
40
Cost
62.3

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3543 T313OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Matthew L. Sprowl, MD, Inc. CurrentSince Sep 22, 2003 Accepting new patients
Dayton Glaucoma and Cataract Consultants CurrentSince Jan 1, 2021 Accepting new patients
Stahl Vision Inc Optometrist PastSince Oct 1, 1999 Accepting new patients

Locations

1222 S Patterson Blvd
Dayton, OH 45402
Phone (937) 229-9706

1222 S Patterson Blvd
Ste 300
Dayton, OH 45402
Phone (937) 224-0024

617 Shroyer Rd
Dayton, OH 45419
Phone (937) 296-1126

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778803200000",
    "number": "1184688384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 SHROYER ROAD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454194055",
            "telephone_number": "937-461-1111",
            "fax_number": "937-224-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 SHROYER ROAD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454194055",
            "telephone_number": "937-461-1111",
            "fax_number": "937-224-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRACOFE",
        "first_name": "GREGORY",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2026-05-15",
        "certification_date": "2026-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3543 T313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0979213",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.