Doctor profile · Federal record
Dr. Kenneth Kisamore, OD
Optometrist (CMS: Optometry) · Optometrist · Rockville, MD
- NPI 1154364800
- Accepts Medicare
- 41 yrs in practice
- Licensed in 2 states
- Male
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
14929 Shady Grove RD Unit K
Rockville, MD 208507728
(301) 424-1050
fax (301) 424-3184 - Additional location
-
1841 Fountain Dr
Reston, VA 201903326
(703) 264-2020
fax (703) 481-9474 - Mailing address
-
8614 Westwood Center Dr Fl 9
Vienna, VA 221822442
Credentials & registration
- NPI registered
- June 2006 — 20 yrs on file
- Profile last updated
- July 24, 2024
- Year of graduation
- 1985 — 41 yrs since
- Specialty taxonomy
- 152W00000X — NUCC code
- State licenses (2)
- Maryland #TA0917 · Virginia #0618001710
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1154364800. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$217
Transactions
4
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| CooperVision Inc. | 4 | $217.01 |
By nature of payment
Frequently asked questions
What is Dr. Kenneth Kisamore's medical specialty?
Dr. Kenneth Kisamore practices Optometrist in Rockville, MD.
Where does Dr. Kenneth Kisamore practice?
Dr. Kenneth Kisamore practices at 14929 Shady Grove RD Unit K, Rockville, MD 208507728. Office phone: 3014241050.
What is Dr. Kenneth Kisamore's NPI?
Dr. Kenneth Kisamore's National Provider Identifier (NPI) is 1154364800, issued by NPPES.
Does Dr. Kenneth Kisamore accept Medicare assignment?
Yes. Dr. Kenneth Kisamore accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.