TIDALHEALTH SPECIALTY CARE, LLC
NPI 1053936906
Internal Medicine - Cardiovascular Disease in Salisbury, MD

NPI Status: Active since June 16, 2020

Contact Information

106 MILFORD ST
SALISBURY, MD
ZIP 21804
Phone: (410) 334-2227

Get Directions Write a Review

  • Organization
  • Internal Medicine
  • Cardiovascular Disease
  • CLIA Number: 21D0967451
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 11-14-2025

About TIDALHEALTH SPECIALTY CARE, LLC

This page provides the complete NPI Profile along with additional information for Tidalhealth Specialty Care, Llc, an internist established in Salisbury, Maryland operating as a Internal Medicine, focusing in cardiovascular disease . The healthcare provider is registered in the NPI registry with number 1053936906 assigned on June 2020. The practitioner's primary taxonomy code is 207RC0000X. The provider is registered as an organization and their NPI record was last updated one year ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's . The authorized official of this NPI record is William Pelot (Chief Administrative Officer)

NPI
1053936906
Provider Legal Name
TIDALHEALTH SPECIALTY CARE, LLC
Other Organization Name
Other Name Type
(6)
Entity Type
Organization
Location Address
106 MILFORD ST SALISBURY, MD 21804
Location Phone
(410) 334-2227
Mailing Address
PO BOX 825461 PHILADELPHIA, PA 19182
Is Sole Proprietor?
No
Is Organization Subpart?
Yes
Enumeration Date
06-16-2020
Last Update Date
07-22-2025
Code Navigator

An internist like Tidalhealth Specialty Care, Llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Secondary Locations

  • 100 E Carroll St
    Salisbury, MD 21801
    (410) 912-6400
  • 400 Eastern Shore Dr
    Salisbury, MD 21804
    (410) 749-8906
  • 9733 Healthway Dr
    Berlin, MD 21811
    (410) 334-2227
  • 801 Middleford Rd
    Seaford, DE 19973
    (302) 629-6611
  • 200 Federal St
    Seaford, DE 19973
    (302) 629-3251
  • 11107 Cathage Road Suite 201
    Berlin, MD 21811
    (410) 629-0888

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine Cardiovascular Disease

Taxonomy Code
207RC0000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Group Taxonomy 193400000X MULTIPLE SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

WILLIAM PELOT

Authorized Official Title
CHIEF ADMINISTRATIVE OFFICER
Authorized Official Phone
(410) 543-7497

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
21D0967451
Facility Type
Physician Office
Certificate Effective Date
November 15, 2023
Certificate Expiration Date
November 14, 2025
Laboratory Director
DR. MARK G. TREUTH
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Tidalhealth Specialty Care, Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

Reviews for TIDALHEALTH SPECIALTY CARE, LLC

There are currently no reviews for this provider. Be the first person to share your experience with this provider by filling out our review form. Your insights are appreciated and will help others make informed decisions.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053936906, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
3
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
0
Doubled → 0
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 9 → 18 → 9 6 → 12 → 3 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 1 + 8 + 3 + 1 + 2 + 9 + 0 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1053936906.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Internal Medicine (Interventional Cardiology)
106 MILFORD ST, SUITE 605
SALISBURY, MD 21804
Internal Medicine (Interventional Cardiology)
106 MILFORD ST, SUITE 605
SALISBURY, MD 21804
Podiatrist
106 MILFORD ST, STE 504A
SALISBURY, MD 21804
Podiatrist
106 MILFORD ST, SUITE 504-A
SALISBURY, MD 21804
Internal Medicine
106 MILFORD ST, SUITE 103
SALISBURY, MD 21804
Clinic/Center (Magnetic Resonance Imaging (MRI))
106 MILFORD ST, SUITE 602
SALISBURY, MD 21804
Nurse Practitioner
106 MILFORD ST, STE 201
SALISBURY, MD 21804
Nurse Practitioner (Adult Health)
106 MILFORD ST, SUITE605
SALISBURY, MD 21804
Psychologist (Clinical Child & Adolescent)
106 MILFORD ST, SUITE 104
SALISBURY, MD 21804
Internal Medicine
106 MILFORD ST, SUITE 306
SALISBURY, MD 21804
Psychiatry & Neurology (Psychiatry)
106 MILFORD ST, SUITE 306
SALISBURY, MD 21804
Podiatrist
106 MILFORD ST, SUITE 504A
SALISBURY, MD 21804
Podiatrist
106 MILFORD ST, SUITE 504-A
SALISBURY, MD 21804
Plastic Surgery
106 MILFORD ST, STE. 305
SALISBURY, MD 21804
Podiatrist
106 MILFORD ST, SUITE 403
SALISBURY, MD 21804
Specialist
106 MILFORD ST, SUITE 701
SALISBURY, MD 21804
Dentist (General Practice)
106 MILFORD ST, SUITE 106
SALISBURY, MD 21804
Specialist
106 MILFORD ST, SUITE 105
SALISBURY, MD 21804
Psychologist (Clinical)
106 MILFORD ST, SUITE 104
SALISBURY, MD 21804
Internal Medicine
106 MILFORD ST, STE 504B
SALISBURY, MD 21804

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053936906, enumerated as an "organization" on June 16, 2020.

The provider is located at 106 MILFORD ST SALISBURY, MD 21804 and the phone number is (410) 334-2227.

Internal Medicine with taxonomy code 207RC0000X and a focus in Cardiovascular Disease.