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PRIME MEDICINE LLC
NPI 1134319395
Internal Medicine in Glenn Dale, MD

Active since July 25, 2007CLIA 21D2089125 · Waiver
12150 ANNAPOLIS RD, SUITE 308, GLENN DALE, MD 20769(301) 805-0006(301) 805-5757 Get Directions Write a Review

NPPES record last updated: December 9, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Prime Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PRIME MEDICINE LLC (NPI 1134319395) is a healthcare organization registered as an internal medicine in Glenn Dale, Maryland and active in the NPI registry since July 2007. The organization holds a CLIA Waiver certificate valid through December 18, 2026 and lists Farhad Jamali, Owner, as its authorized official.

NPPES Registry Identity

NPI1134319395
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePRIME MEDICINE LLC
Location Address12150 ANNAPOLIS RD, SUITE 308Glenn Dale, MD 20769-9183
Mailing AddressPo Box 569Greenbelt, MD 20768-0569 · (301) 805-0006 · Fax (301) 805-5757
Phone(301) 805-0006
Fax(301) 805-5757
Organization SubpartNo
Authorized OfficialFarhad JamaliOwner · (301) 805-0006
Enumeration DateJuly 25, 2007
Last NPPES UpdateDecember 9, 2011
✔ NPI 1134319395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MD · D0058213
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
12150 ANNAPOLIS RD, Glenn Dale, MD 20769
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Other Identifiers 2

Medicaid415340500MD
Medicare PIN130785DC

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2089125

Prime Medicine LLC · Glenn Dale, MD
Active · expires Dec 18, 2026
CLIA Number21D2089125
Laboratory TypePhysician Office
Certificate Effective DateDecember 19, 2024
Certificate Expiration DateDecember 18, 2026
Laboratory DirectorFarhad Jamali MD
Laboratory Phone(301) 565-2250
Laboratory LocationPrime Medicine LLC12150 Annapoils Road Suite 308, Glenn Dale, MD 20769
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ARNOLD S KIRSHENBAUM MD PA
Specialist
12150 ANNAPOLIS RD, SUITE #108
GLENN DALE, MD 20769
Prince George's County (301) 860-1200
ELAINE YOUNG BUNDY CRNP
Nurse Practitioner
12150 ANNAPOLIS RD, SUITE 108
GLENN DALE, MD 20769
Prince George's County (301) 860-1200
NWAEHIHIE HARRISON ONYEAGHALA MD
General Practice
12150 ANNAPOLIS RD, SUITE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601
THE BARIATRIC AND HERNIA INSTITUTE, PC
Surgery
12150 ANNAPOLIS RD, SUITE 309
GLENN DALE, MD 20769
Prince George's County (240) 206-8506
KRYSTAL MEDICAL ASSOCIATES LLC
Clinic/Center (Primary Care)
12150 ANNAPOLIS RD, SUITE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601
DR. OCTAVIA S SIMKINS-WISEMAN DDS
Dentist (General Practice)
12150 ANNAPOLIS RD, SUITE301
GLENN DALE, MD 20769
Prince George's County (301) 249-8000
RICARDO O PYFROM MD PA
Orthopaedic Surgery
12150 ANNAPOLIS RD, SUITE 305
GLENN DALE, MD 20769
Prince George's County (301) 809-2515
MUSA MARK MOMOH MD
Internal Medicine
12150 ANNAPOLIS RD, SUITE 205
GLENN DALE, MD 20769
Prince George's County (301) 805-1103

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Prime Medicine LLC's NPI number?

The NPI number for Prime Medicine LLC is 1134319395. It was assigned to this organization in the NPPES registry on July 25, 2007.

Where is Prime Medicine LLC located?

Prime Medicine LLC is located at 12150 Annapolis Rd Suite 308, Glenn Dale, MD 20769. The listed phone number is (301) 805-0006.

What is Prime Medicine LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Prime Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2089125) is associated with this NPI, valid through December 18, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Prime Medicine LLC was last updated on December 9, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.