Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kenneth Kisamore, OD

Individual provider Optometrist · NPI 1154364800

Kenneth Kisamore, OD is an Optometry in Rockville, Maryland. Graduated from Pennsylvania State University College of Medicine in 1985, 41 years ago. Practices with Rockville Optometry, LLC, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Maryland and Virginia.

Years since qualifying
41
Trained at
Pennsylvania State University College of Medicine
Licensed in
MD, VA
In the registry since
2006
Specialties on file
2
What do these letters mean?
OD — Doctor of Optometry
An optometrist: examines eyes, prescribes glasses and contacts, and treats many eye conditions.

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Practice location Address checks out

14929 Shady Grove Rd Unit K
Rockville, MD 20850-7728
Phone: (301) 424-1050
Fax: (301) 424-3184
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1841 Fountain Dr, Reston, VA 20190-3326 — (703) 264-2020

Specialties & licences

Optometrist (primary) Taxonomy 152W00000X · Licence TA0917 (MD)
Optometrist Taxonomy 152W00000X · Licence 0618001710 (VA)

Record details

NPI number1154364800
Entity typeIndividual (Type 1)
GenderMale
Credentials OD
Sole proprietorNo
NPI enumeratedJune 13, 2006
Last updated in NPPESJuly 24, 2024
Certification dateJuly 24, 2024
Mailing address8614 Westwood Center Dr Fl 9, Vienna, VA 22182-2442

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPTOMETRY
Medical schoolPENNSYLVANIA STATE UNIVERSITY COLLEGE OF MEDICINE
Graduated 1985 (41 years in practice)
Group practice Rockville Optometry, Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rockville