Kenneth Kisamore, OD - Medicare Optometrist in Rockville, MD

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



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

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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

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Provider NameRockville Optometry, Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1548325798
PECOS PAC ID: 8729180112
Enrollment ID: O20070305000335

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Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1891850038
PECOS PAC ID: 5890898969
Enrollment ID: O20070309000216

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Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1538307962
PECOS PAC ID: 6800072224
Enrollment ID: O20120905000226

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Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1275774234
PECOS PAC ID: 6305094434
Enrollment ID: O20120914000662

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Provider IdentifiersNPI Number: 1497124796
PECOS PAC ID: 6002037629
Enrollment ID: O20151102002293

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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

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Optometrist in Rockville, MD

Alice P Laflamme, OD
Optometrist
Medicare: Medicare Enrolled
Practice Location: 3204 Tower Oaks Blvd Ste 300, Rockville, MD 20852
Phone: 301-231-5088    
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Optometrist
Medicare: Medicare Enrolled
Practice Location: 15200 Shady Grove Rd, Suite 100, Rockville, MD 20850
Phone: 301-670-1212    Fax: 301-216-9692
Pioneer Optical Company
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 50 W Edmonston Dr Ste 103, Rockville, MD 20852
Phone: 301-251-6735    
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Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 4110 Aspen Hill Rd, 300, Rockville, MD 20853
Phone: 301-871-0180    Fax: 301-871-0179
Sheila Wood, OD
Optometrist
Medicare: Not Enrolled in Medicare
Practice Location: 11802 Rockville Pike Ste B, Rockville, MD 20852
Phone: 301-770-7780    Fax: 301-770-1433
Chun H Auyeung, O.D
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 5576 Norbeck Rd Unit B, Rockville, MD 20853
Phone: 301-238-7199    Fax: 301-977-4664
Ms. Rosa Nilo Dastrange, O.D.
Optometrist
Medicare: Accepting Medicare Assignments
Practice Location: 9850 Key West Ave, Rockville, MD 20850
Phone: 240-314-0160    

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