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LJ MEDICAL LLC
NPI 1750993663
Family Medicine in Rockville, MD

Active since August 21, 2020CLIA 21D2216766 · Waiver
121 CONGRESSIONAL LN STE 204, ROCKVILLE, MD 20852(301) 917-4139(877) 803-4509 Get Directions Write a Review

NPPES record last updated: April 30, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 12, 2021, Aug 21, 2020 (2 updates tracked since 2020).

About Lj Medical Llc NPPES

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

LJ MEDICAL LLC (NPI 1750993663) is a healthcare organization registered as a family medicine in Rockville, Maryland and active in the NPI registry since August 2020. The organization holds a CLIA Waiver certificate valid through March 15, 2027 and lists Malvis Tamon, Ceo, as its authorized official.

NPPES Registry Identity

NPI1750993663
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLJ MEDICAL LLC
Location Address121 CONGRESSIONAL LN STE 204Rockville, MD 20852-1542
Mailing Address121 Congressional Ln Ste 204Rockville, MD 20852-1542 · (301) 917-4139 · Fax (877) 803-4509
Phone(301) 917-4139
Fax(877) 803-4509
Organization SubpartNo
Authorized OfficialMalvis TamonCeo · (240) 426-3316
Enumeration DateAugust 21, 2020
Last NPPES UpdateApril 30, 20252 updates tracked since enumeration
NPPES CertifiedApril 30, 2025
✔ NPI 1750993663 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
121 CONGRESSIONAL LN STE 204, Rockville, MD 20852
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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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lj Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Lj Medical LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Malvis Tamon, DNP, APRN, FNP-BC
Nurse Practitioner
NPI 1679059794
300 BALLENGER CENTER DR
Frederick, MD 21703
(301) 682-7213
✔ PECOS✔ Accepts Medicare28 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 21D2216766

Lj Medical Health And Wellness Clinic · Rockville, MD
Active · expires Mar 15, 2027
CLIA Number21D2216766
Laboratory TypePhysician Office
Certificate Effective DateMarch 16, 2025
Certificate Expiration DateMarch 15, 2027
Laboratory DirectorMalvis N. Tamon
Laboratory Phone(301) 917-4139
Laboratory LocationLj Medical Health And Wellness Clinic121 Congressional Lane Ste 204, Rockville, MD 20852
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Lj Medical LLC's NPI number?

The NPI number for Lj Medical LLC is 1750993663. It was assigned to this organization in the NPPES registry on August 21, 2020.

Where is Lj Medical LLC located?

Lj Medical LLC is located at 121 Congressional Ln Ste 204, Rockville, MD 20852. The listed phone number is (301) 917-4139.

What is Lj Medical LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Lj Medical LLC enrolled in Medicare?

Yes. Lj Medical LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Lj Medical LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Lj Medical LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Lj Medical LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2216766) is associated with this NPI, valid through March 15, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Lj Medical LLC was last updated on April 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months 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.