TIDALHEALTH PRIMARY CARE, LLC
NPI 1104453208
Family Medicine in Salisbury, MD
NPI Status: Active since March 26, 2020
Contact Information
100 E CARROLL ST
SALISBURY, MD
ZIP 21801
Phone: (410) 546-6400
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 21D0649930
- CLIA Cert. Type: Hospital
- CLIA Exp. Date: 08-16-2027
About TIDALHEALTH PRIMARY CARE, LLC
This page provides the complete NPI Profile along with additional information for Tidalhealth Primary Care, Llc, a primary care provider established in Salisbury, Maryland operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1104453208 assigned on March 2020. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated one year ago. The provider's
- NPI
- 1104453208
- Provider Legal Name
- TIDALHEALTH PRIMARY CARE, LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 100 E CARROLL ST SALISBURY, MD 21801
- Location Phone
- (410) 546-6400
- Mailing Address
- 100 E CARROLL ST SALISBURY, MD 21801
- Mailing Phone
- (410) 912-4976
- Mailing Fax
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-26-2020
- Last Update Date
- 07-22-2025
- Code Navigator
A primary care provider (PCP) like Tidalhealth Primary Care, Llc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 30265 Commerce Dr Suite 206
Millsboro, DE 19966
(302) 732-8400 - 100 E Carroll St
Salisbury, MD 21801
(410) 912-6400 - 201 Hall Hwy
Crisfield, MD 21817
(410) 968-1801 - 305 10th St Ste 101
Pocomoke City, MD 21851
(410) 912-4950 - 9950 N Main St
Berlin, MD 21811
(410) 912-6710 - 428 W Market St
Snow Hill, MD 21863
(410) 912-4950 - 145 E Carroll St
Salisbury, MD 21801
(410) 912-5785 - 11101 Cathage Rd
Ocean Pines, MD 21811
(410) 912-6104 - 1639 Woodbrooke Dr
Salisbury, MD 21804
(410) 912-5785
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
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- AmeriHealth Caritas Next Bronze Essential + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Premier + No Referrals - HMO
- AmeriHealth Caritas Next Bronze Signature + No Referrals - HMO
- AmeriHealth Caritas Next Gold Premier + No Referrals - HMO
- AmeriHealth Caritas Next Gold Signature + No Referrals - HMO
- AmeriHealth Caritas Next Silver Essential + No Referrals - HMO
- AmeriHealth Caritas Next Silver Premier + No Referrals - HMO
- AmeriHealth Caritas Next Silver Signature + No Referrals - HMO
- my Blue Access Major Events Select PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
- my Blue Access Select PPO Bronze 3800 - PPO
- my Blue Access Select PPO Bronze 3800 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Bronze 9200 - PPO
- my Blue Access Select PPO Gold 0 - PPO
- my Blue Access Select PPO Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Gold 1700 HSA - PPO
- my Blue Access Select PPO Premier Gold 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Platinum 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Premier Silver 0 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Standard Bronze 7500 - PPO
- my Blue Access Select PPO Standard Gold 2000 - PPO
- my Blue Access Select PPO Standard Gold 2000 + Adult Dental and Vision - PPO
- my Blue Access Select PPO Standard Platinum 0 - PPO
- my Blue Access Select PPO Standard Silver 6000 - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
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
- 21D0649930
- Facility Type
- Hospital
- Certificate Effective Date
- August 17, 2025
- Certificate Expiration Date
- August 16, 2027
- Laboratory Director
- KIMBERLY CUESTA
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Tidalhealth Primary Care, Llc on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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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 1104453208, we treat the final digit (8) 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 52. The final step is to find the difference between that total and the next multiple of ten (60 - 52 = 8).
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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 52 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
SALISBURY, MD 21801
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1104453208, enumerated as an "organization" on March 26, 2020.
The provider is located at 100 E CARROLL ST SALISBURY, MD 21801 and the phone number is (410) 546-6400.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: AmeriHealth Caritas Next and Highmark Blue Cross. Please consult your insurance carrier or call the provider to verify.
