Individual provider Active NPI

William Kegerize, OD

  • Optometrist
  • Genoa, OH
National Provider Identifier
1306847157
Registry record updated Aug 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5558 Issued in OH
Practice address
618 Main St
Genoa, OH 43430-1636
Phone
(419) 855-3640
Fax
(419) 855-4743
NPI assigned
Aug 2, 2005
Last updated
Aug 31, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 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 5558 OH Primary

Addresses

Primary practice location

618 Main St
Genoa, OH 43430-1636

Mailing address

618 Main St
Genoa, OH 43430-1636
Phone (419) 855-3640

Other identifiers 3

IdentifierTypeStateIssuer
P01300310OtherOHRAILROAD MEDICARE
5558OtherOHSTATE LICENSE NUMBER
3037403MedicaidOH

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
I20061003000340 OH Practitioner - Optometry 0345245965 Reassigns benefits to 1 organization
Practice locations: Oregon, OH

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Ohio State University - College of Optometry, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

603 Main St
Genoa, OH 43430-1635
Phone (419) 855-3640

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5558OHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Quality Family Eyecare, Inc Optometrist PastSince Oct 1, 2000 Accepting new patients
James Optical Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: william.kegerize@direct.revolutionehr.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788134400000",
    "number": "1306847157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 MAIN ST",
            "city": "GENOA",
            "state": "OH",
            "postal_code": "434301636",
            "telephone_number": "419-855-3640",
            "fax_number": "419-855-4743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 MAIN ST",
            "city": "GENOA",
            "state": "OH",
            "postal_code": "434301636",
            "telephone_number": "419-855-3640",
            "fax_number": "419-855-4743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEGERIZE",
        "first_name": "WILLIAM",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-02",
        "last_updated": "2026-08-31",
        "certification_date": "2026-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "5558",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01300310",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "5558",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3037403",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Genoa, OH

Sources for this page

Verify at the official NPI Registry.