NPIMap

Organization Active NPI

Comprehensive Primary Care and Associates, LLC

  • Family Medicine Physician
  • Waldorf, MD
National Provider Identifier
1417815127
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC
Practice address
3716 Crain Hwy
Waldorf, MD 20603-4890
Phone
(301) 869-9776
Fax
(301) 417-4947
NPI assigned
Jan 12, 2026
Last updated
Jan 12, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Konstantin A Khludenev, MDNPI 1538154075
Title
Co-Chief Executive Officer
Phone
(301) 869-9776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Internal Medicine Physician 207R00000X

Addresses

Primary practice location

3716 Crain Hwy
Waldorf, MD 20603-4890

Mailing address

15245 Shady Grove Rd Ste 340
Rockville, MD 20850-7201
Phone (301) 869-9776

National Provider Directory

National Provider Directory
Tax ID family
Comprehensive Primary Care26 organizations share this tax ID, including this one
Part of
Comprehensive Primary Care

Other organizations with this tax ID 25

Organizations that report the same tax identification number in the National Provider Directory.

View all 25

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1768176000000",
    "number": "1417815127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15245 SHADY GROVE RD STE 340",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208507201",
            "telephone_number": "301-869-9776",
            "fax_number": "301-417-4947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3716 CRAIN HWY",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034890",
            "telephone_number": "301-869-9776",
            "fax_number": "301-417-4947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COMPREHENSIVE PRIMARY CARE AND ASSOCIATES, LLC",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A",
        "authorized_official_last_name": "KHLUDENEV",
        "authorized_official_first_name": "KONSTANTIN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CO-CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "301-869-9776",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.