TIDALHEALTH PRIMARY CARE, LLC
NPI 1104453208
Family Medicine in Salisbury, MD
About Tidalhealth Primary Care, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIDALHEALTH PRIMARY CARE, LLC (NPI 1104453208) is a healthcare organization registered as a family medicine in Salisbury, Maryland and active in the NPI registry since March 2020. The organization holds 7 active CLIA laboratory certificates, maintains 9 additional practice locations, and lists William Pelot, Chief Administrator Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Secondary Practice Locations 9
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Tidalhealth Primary Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
95Medicare enrollment records show 95 clinicians reassign Medicare billing to Tidalhealth Primary Care, LLC, which bills Medicare for the services they deliver. Of these, 6 practice at this address and 37 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 13
Nearest to this location (20)
See all 95Source: 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 7
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 for Provider-Performed Microscopy Procedures (PPMP) 08D1000923
Tidalhealth Primary Care · Millsboro, DECertificate of Waiver 21D1058742
Tidalhealth Primary Care - Snow Hill · Snow Hill, MDCertificate of Waiver 21D2180668
Tidalhealth Primary Care · Crisfield, MDCertificate of Waiver 21D2094252
Tidalhealth Primary Care · Salisbury, MDCertificate of Accreditation 21D0649930
Tidalhealth Mccready Pavilion · Crisfield, MDCertificate of Waiver 21D2198788
Tidalhealth Primary Care · Berlin, MDFrequently 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 Tidalhealth Primary Care, LLC's NPI number?
The NPI number for Tidalhealth Primary Care, LLC is 1104453208. It was assigned to this organization in the NPPES registry on March 26, 2020. The provider is also known as TidalHealth Community Wellness.
Where is Tidalhealth Primary Care, LLC located?
Tidalhealth Primary Care, LLC is located at 100 E Carroll St, Salisbury, MD 21801. The listed phone number is (410) 546-6400.
What is Tidalhealth Primary Care, LLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Tidalhealth Primary Care, LLC enrolled in Medicare?
Yes. Tidalhealth Primary Care, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Tidalhealth Primary Care, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 95 clinicians in 13 Medicare specialties reassign their Medicare billing to Tidalhealth Primary Care, 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. The largest specialties are Nurse Practitioner (35), Family Practice (25) and Internal Medicine (20). Of these, 6 practice at this address and 37 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Tidalhealth Primary Care, LLC hold CLIA laboratory certificates?
Yes. 7 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Tidalhealth Primary Care, LLC accept?
Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list Tidalhealth Primary Care, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Tidalhealth Primary Care, LLC was last updated on July 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.
# Tidalhealth Primary Care, Llc · NPI 1104453208
Family Medicine organization in Salisbury, Maryland. Organization record, active in the CMS NPPES registry since March 26, 2020.
## Identity
- **NPI:** 1104453208 (Entity type: Organization)
- **Enumerated:** March 26, 2020
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** TidalHealth Community Wellness (Other Name)
- **Organization subpart:** No
- **Authorized official:** William Pelot, CHIEF ADMINISTRATOR OFFICER
## Practice location
- **Address:** 100 E CARROLL ST, Salisbury, MD 21801-5422
- **Phone:** (410) 546-6400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 95 clinicians in 13 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (35), Family Practice (25), Internal Medicine (20); 6 practice at this address and 37 within 10 miles; [full list](https://npiprofile.com/npi/1104453208/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 22, 2025
- **CLIA laboratory certificates:** 7 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104453208) · Data from the CMS NPPES public registry.