William Kegerize OD LLC
Organization Active NPI Exclusive Provider Organization · Genoa, OH
NPI 1972834307 · NPPES record last updated Aug 31, 2026
Key facts
- NPI
- 1972834307
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Exclusive Provider Organization 302F00000X
- License
- OH5558 (OH)
- Legal business name
- WILLIAM KEGERIZE OD LLC
- Practice address
- 618 Main St
Genoa, OH 43430-1636 - Phone
- (419) 855-3640
- Fax
- (419) 855-4743
- NPI assigned
- Jan 25, 2010
- Organization subpart
- Yes
- Parent organization (as reported)
- WILLIAM KEGERIZE OD LLC
Authorized official
- Name
- William Kegerize, OD
- Title
- OD
- Phone
- (419) 855-3640
Practitioners 2
-
William Kegerize, OD
-
Dennis R Laub, O.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100819000477 | OH | Part B Supplier - Clinic/Group Practice | 4183763949 |
Receives reassigned benefits from 1 practitioner Practice locations: Genoa, OH |
National Provider Directory
- Part of
- William Kegerize OD LC
Locations
603 Main St
Genoa, OH 43430
Phone (419) 855-3640
626 Main St
Genoa, OH 43430
Phone (419) 855-3640
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | OH5558 | OH | Yes |
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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3037403 | Medicaid | OH |
Other names
- Genoa Family Eyecare
Other providers in Genoa, OH
- Trilogy Healthcare of Ottawa, LLC
- Griffin Van Nest
- Latanya Van Nest
- Debbie Meri Verkin-Siebert
- Heather Weaver
- Dominique Celeste Wright
- Jessica Zaciewski
All providers in Genoa, OH · Exclusive Provider Organization in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.