Kenneth Kisamore, OD - Medicare Optometrist in Rockville, MD

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Kenneth Kisamore, OD is a medicare enrolled "Optometrist" provider in Rockville, Maryland. He went to Pennsylvania State University College Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Rockville Optometry, Llc and his current practice location is 14929 Shady Grove Rd Unit K, Rockville, Maryland. You can reach out to his office (for appointments etc.) via phone at (301) 424-1050.

Kenneth Kisamore is licensed to practice in Maryland (license number TA0917) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154364800.

Contact Information

Kenneth Kisamore, OD
14929 Shady Grove Rd Unit K,
Rockville, MD 20850-7728
(301) 424-1050
(301) 424-3184

Map and Direction




Healthcare Provider's Profile

Full NameKenneth Kisamore
GenderMale
SpecialityOptometry
Experience39 Years
Location14929 Shady Grove Rd Unit K, Rockville, Maryland
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Kenneth Kisamore attended and graduated from Pennsylvania State University College Of Medicine in 1985
  NPI Data:
  • NPI Number: 1154364800
  • Provider Enumeration Date: 06/13/2006
  • Last Update Date: 12/10/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4082717475
  • Enrollment ID: I20070305000351

Medical Identifiers

Medical identifiers for Kenneth Kisamore such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1154364800NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist 0618001710 (Virginia)Secondary
152W00000XOptometrist TA0917 (Maryland)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Rockville Optometry, Llc87291801124

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Kenneth Kisamore allows following entities to bill medicare on his behalf.
Provider NameRockville Pike Optometry, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1710043278
PECOS PAC ID: 4688776313
Enrollment ID: O20070226000722
Provider NameRockville Optometry, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1548325798
PECOS PAC ID: 8729180112
Enrollment ID: O20070305000335
Provider NameMiller Eyecare Reston, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1891850038
PECOS PAC ID: 5890898969
Enrollment ID: O20070309000216
Provider NameCabin John Optometry Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1538307962
PECOS PAC ID: 6800072224
Enrollment ID: O20120905000226
Provider NameKentlands Optometry Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1275774234
PECOS PAC ID: 6305094434
Enrollment ID: O20120914000662
Provider NameMyeyedr Optometry Of Maryland Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1497124796
PECOS PAC ID: 6002037629
Enrollment ID: O20151102002293

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Kisamore is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Kenneth Kisamore, OD
1950 Old Gallows Rd Ste 520,
Vienna, VA 22182-3970

Ph: (703) 847-8899		Kenneth Kisamore, OD
14929 Shady Grove Rd Unit K,
Rockville, MD 20850-7728

Ph: (301) 424-1050

Reviews and Comments


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Chun H Auyeung, O.D
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Ms. Rosa Nilo Dastrange, O.D.
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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.