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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

KRYSTAL MEDICAL ASSOCIATES LLC
NPI 1164604187
Clinic/Center - Primary Care in Glenn Dale, MD

Active since November 30, 2007
12150 ANNAPOLIS RD STE 100, GLENN DALE, MD 20769(301) 464-7601(866) 885-9817 Get Directions Write a Review

NPPES record last updated: September 4, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 4, 2026, Aug 25, 2026 (2 updates tracked since 2026).

About Krystal Medical Associates Llc NPPES

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

KRYSTAL MEDICAL ASSOCIATES LLC (NPI 1164604187), doing business as Krystal Medical Associates, is a healthcare organization registered as a primary care in Glenn Dale, Maryland and active in the NPI registry since November 2007. The organization maintains a secondary practice location in Washington and lists Nwaehihie Harrison Onyeaghala, Owner, as its authorized official.

NPPES Registry Identity

NPI1164604187
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameKRYSTAL MEDICAL ASSOCIATES LLC
Location Address12150 ANNAPOLIS RD STE 100Glenn Dale, MD 20769-9183
Mailing AddressPo Box 7321Largo, MD 20792-7321 · (301) 464-7601 · Fax (866) 885-9817
Phone(301) 464-7601
Fax(866) 885-9817
Organization SubpartNo
Authorized OfficialNwaehihie Harrison OnyeaghalaOwner · (301) 464-7601
Enumeration DateNovember 30, 2007
Last NPPES UpdateSeptember 4, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 4, 2026
✔ NPI 1164604187 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MD · D0053461
Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X · License D0053461 (MD)
12150 ANNAPOLIS RD STE 100, Glenn Dale, MD 20769
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Other Names 1

Doing Business AsKrystal Medical Associates

Secondary Practice Location 1

Location 1650 Pennsylvania Ave SEWashington, DC 20003-4318 · Phone (301) 464-7601 · Fax (866) 885-9817

Other Identifiers 4

Medicaid034934800DC
Medicaid010012902VA
Medicaid402647100MD
Medicaid552123800MD

Other Providers at the Same Location NPPES 4

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

NWAEHIHIE HARRISON ONYEAGHALA MD
General Practice
12150 ANNAPOLIS RD STE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601
PRUDENCE AYUK FNP
Nurse Practitioner (Family)
12150 ANNAPOLIS RD STE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601
ISAAC OSEI OWUSU NP
Nurse Practitioner (Family)
12150 ANNAPOLIS RD STE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601
DARLINGTON NWOKE UCHECHUKWU
Nurse Practitioner (Family)
12150 ANNAPOLIS RD STE 100
GLENN DALE, MD 20769
Prince George's County (301) 464-7601

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 Krystal Medical Associates LLC's NPI number?

The NPI number for Krystal Medical Associates LLC is 1164604187. It was assigned to this organization in the NPPES registry on November 30, 2007. The provider is doing business as Krystal Medical Associates.

Where is Krystal Medical Associates LLC located?

Krystal Medical Associates LLC is located at 12150 Annapolis Rd Ste 100, Glenn Dale, MD 20769. The listed phone number is (301) 464-7601.

What is Krystal Medical Associates LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Krystal Medical Associates LLC was last updated on September 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.