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EDGE FAMILY MEDICINE LLC
NPI 1801517453
Family Medicine in Riverdale, MD

Active since September 12, 2022CLIA 21D2274819 · Waiver
5305 KENILWORTH AVE # 100, RIVERDALE, MD 20737(301) 277-7110 Get Directions Write a Review

NPPES record last updated: September 12, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Edge Family Medicine Llc NPPES

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

EDGE FAMILY MEDICINE LLC (NPI 1801517453) is a healthcare organization registered as a family medicine in Riverdale, Maryland and active in the NPI registry since September 2022. The organization holds a CLIA Waiver certificate valid through January 10, 2027 and lists Kelechi Ego-osuala, Owner, as its authorized official.

NPPES Registry Identity

NPI1801517453
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameEDGE FAMILY MEDICINE LLC
Location Address5305 KENILWORTH AVE # 100Riverdale, MD 20737-3101
Mailing Address5305 Kenilworth Ave # 100Riverdale, MD 20737-3101 · (301) 277-7110
Phone(301) 277-7110
Organization SubpartNo
Authorized OfficialKelechi Ego-osualaOwner · (301) 613-5376
Enumeration DateSeptember 12, 2022
NPPES CertifiedSeptember 10, 2022
✔ NPI 1801517453 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.
5305 KENILWORTH AVE # 100, Riverdale, MD 20737
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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)

Edge Family Medicine 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 Edge Family Medicine LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Kelechi Ego Osuala
Family Practice
NPI 1841856499
5305 KENILWORTH AVE
Riverdale, MD 20737
(301) 277-7110
✔ PECOS✔ Accepts MedicareSame address

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 21D2274819

Edge Family Medicine LLC · Riverdale, MD
Active · expires Jan 10, 2027
CLIA Number21D2274819
Laboratory TypePhysician Office
Certificate Effective DateJanuary 11, 2025
Certificate Expiration DateJanuary 10, 2027
Laboratory DirectorKelechi Ego-Osuala
Laboratory Phone(301) 277-7110
Laboratory LocationEdge Family Medicine LLC5305 Kenilworth Avenue Unit B, Riverdale, MD 20737
CLIA data matches this NPI record on: 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 Edge Family Medicine LLC's NPI number?

The NPI number for Edge Family Medicine LLC is 1801517453. It was assigned to this organization in the NPPES registry on September 12, 2022.

Where is Edge Family Medicine LLC located?

Edge Family Medicine LLC is located at 5305 Kenilworth Ave # 100, Riverdale, MD 20737. The listed phone number is (301) 277-7110.

What is Edge Family Medicine LLC's specialty?

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

Is Edge Family Medicine LLC enrolled in Medicare?

Yes. Edge Family Medicine LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Edge Family Medicine LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Edge Family Medicine 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 Edge Family Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D2274819) is associated with this NPI, valid through January 10, 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 Edge Family Medicine LLC was last updated on September 12, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.