TIDALHEALTH PENINSULA REGIONAL, INC.
NPI 1184832040
Family Medicine in Salisbury, MD

Q: What is Tidalhealth Peninsula Regional, Inc.'s NPI number?

The NPI number for Tidalhealth Peninsula Regional, Inc. is 1184832040. It was assigned to this organization in the NPPES registry on May 21, 2007.

Q: What is Tidalhealth Peninsula Regional, Inc.'s specialty?

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

Active since May 21, 2007

100 E CARROLL ST, PENINSULA REGIONAL MEDICAL GROUP, SALISBURY, MD 21801(410) 543-7252(410) 912-6386 Get Directions Write a Review

NPPES record last updated: February 28, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Feb 28, 2023, Nov 16, 2020, Oct 15, 2018 (3 updates tracked since 2018).

On this page

About Tidalhealth Peninsula Regional, Inc. NPPES

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

TIDALHEALTH PENINSULA REGIONAL, INC. (NPI 1184832040) is a healthcare organization registered as a family medicine in Salisbury, Maryland and active in the NPI registry since May 2007. The organization lists Stephanie Gary, Cfo, as its authorized official.

NPPES Registry Identity

NPI1184832040

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameTIDALHEALTH PENINSULA REGIONAL, INC.

Location Address100 E CARROLL ST, PENINSULA REGIONAL MEDICAL GROUPSalisbury, MD 21801-5422

Mailing Address100 E Carroll St, Peninsula Regional Medical GroupSalisbury, MD 21801-5422 · (410) 543-7252 · Fax (410) 912-6386

Phone(410) 543-7252

Fax(410) 912-6386

Organization SubpartNo

Authorized OfficialStephanie GaryCfo · (410) 912-6059

Enumeration DateMay 21, 2007

Last NPPES UpdateFebruary 28, 20233 updates tracked since enumeration

NPPES CertifiedFebruary 28, 2023

✔ NPI 1184832040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ 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.

Also ListedEmergency MedicineTaxonomy 207P00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedInternal Medicine · Endocrinology, Diabetes & MetabolismTaxonomy 207RE0101X

Also ListedInternal Medicine · GastroenterologyTaxonomy 207RG0100X

Also ListedInternal Medicine · Hematology & OncologyTaxonomy 207RH0003X

Also ListedInternal Medicine · Pulmonary DiseaseTaxonomy 207RP1001X

Also ListedNeurological SurgeryTaxonomy 207T00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedGeneral PracticeTaxonomy 208D00000X

Also ListedThoracic Surgery (Cardiothoracic Vascular Surgery)Taxonomy 208G00000X

Also ListedClinic/Center · Adult Mental HealthTaxonomy 261QM0850X

Also ListedClinic/Center · Adolescent and Children Mental HealthTaxonomy 261QM0855X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

100 E CARROLL ST, Salisbury, MD 21801

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Other Identifiers 13

OtherCC4271MD · Medicare Rrb

OtherCA8333MD · Medicare Rrb

Medicaid0000241502DE

OtherC10607VA · Medicare Ptan

OtherK230MD · Medicare Nsc

OtherK230MD · Medicare Ptan

Medicaid401428600MD

OtherCA8334DE · Medicare Rrb

OtherG01753DE · Medicare Nsc

Medicaid525701800MD

OtherC10607VA · Medicare Nsc

OtherCC3716MD · Medicare Rrb

OtherG01753DE · Medicare Ptan

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, Highmark Blue Cross Blue Shield Delaware.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 Peninsula Regional, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

169

Medicare enrollment records show 169 clinicians reassign Medicare billing to Tidalhealth Peninsula Regional, Inc., which bills Medicare for the services they deliver. Of these, 50 practice at this address and 103 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 24

Nurse Practitioner52

Internal Medicine39

Cardiovascular Disease (Cardiology)12

Family Practice10

Neurology8

Hospitalist7

Gastroenterology6

Hematology/Oncology5

16 other specialties30

Nearest to this location (20)

See all 169

Mohammad Ahmad, MBBS

Internal Medicine

NPI 1194139451

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Erin Ard, FNP

Nurse Practitioner

NPI 1770966772

100 E CARROLL ST
Salisbury, MD 21801

(410) 543-7536

✔ PECOS✔ Accepts MedicareSame address

Anam Ashfaque, M.D.

Hospitalist

NPI 1982083432

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Habtamu Asrat, MD

Internal Medicine

NPI 1932456449

100 E CARROLL ST
Salisbury, MD 21801

(410) 543-7536

✔ PECOS✔ Accepts MedicareSame address

Nancy Benjamin Jean-Marie, M.D.

Family Practice

NPI 1699724203

100 E CARROLL ST
Salisbury, MD 21801

(410) 543-7536

✔ PECOS✔ Accepts MedicareSame address

William Cerrato, DO

Psychiatry

NPI 1497917942

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Edwana Cottman, LCSW-C

Clinical Social Worker

NPI 1164927448

100 E CARROLL ST # 101102
Salisbury, MD 21801

(410) 630-7685

✔ PECOSSame address

Susan Cottongim, RD,LDN,CDE

Registered Dietitian or Nutrition Professional

NPI 1558586255

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ Accepts MedicareSame address

Jeannette Daum, CRNP

Nurse Practitioner

NPI 1548772577

100 E CARROLL ST
Salisbury, MD 21801

(410) 546-6400

✔ PECOS✔ Accepts MedicareSame address

Thomas Demarco, MD

Urology

NPI 1194786160

100 E CARROLL ST
Salisbury, MD 21801

(410) 543-7252

✔ PECOSSame address

Walid El Ayass, M.D

Hematology/Oncology

NPI 1700078250

100 E CARROLL STREET
Salisbury, MD 21801

(410) 749-1282

✔ PECOS✔ Accepts MedicareSame address

Faran Ghumman, MD

Hospitalist

NPI 1902280449

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Kimberly Gilbert, M.D.

Family Practice

NPI 1740458819

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOSSame address

Alyson Heenan, RD, LDN, CDCES

Registered Dietitian or Nutrition Professional

NPI 1285106393

100 E CARROLL ST
Salisbury, MD 21801

(410) 546-6400

✔ Accepts MedicareSame address

Fawad Khan, MD

Cardiovascular Disease (Cardiology)

NPI 1417183435

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Saima Maqsood, M.D.

Psychiatry

NPI 1629276985

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

Eric Ofori, MD

Nephrology

NPI 1104057751

100 E CARROLL ST
Salisbury, MD 21801

(410) 546-6400

✔ PECOS✔ Accepts MedicareSame address

Yashvir Sangwan, M.D

Pulmonary Disease

NPI 1205097698

100 E CARROLL ST DIVISION OF PULMONARY AND CRITICAL CARE
Salisbury, MD 21801

(410) 546-6400

✔ PECOS✔ Accepts MedicareSame address

Channaiah Srikanth Mysore

Neurology

NPI 1881900652

100 E CARROLL ST
Salisbury, MD 21801

(800) 749-5191

✔ PECOS✔ Accepts MedicareSame address

James Todd, MD

Thoracic Surgery

NPI 1831165570

100 E CARROLL ST
Salisbury, MD 21801

(410) 546-1353

✔ PECOS✔ Accepts MedicareSame address

See all 169 clinicians

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Tidalhealth Peninsula Regional, Inc.'s NPI number?

The NPI number for Tidalhealth Peninsula Regional, Inc. is 1184832040. It was assigned to this organization in the NPPES registry on May 21, 2007.

Where is Tidalhealth Peninsula Regional, Inc. located?

Tidalhealth Peninsula Regional, Inc. is located at 100 E Carroll St Peninsula Regional Medical Group, Salisbury, MD 21801. The listed phone number is (410) 543-7252.

What is Tidalhealth Peninsula Regional, Inc.'s specialty?

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

Is Tidalhealth Peninsula Regional, Inc. enrolled in Medicare?

Yes. Tidalhealth Peninsula Regional, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidalhealth Peninsula Regional, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 169 clinicians in 24 Medicare specialties reassign their Medicare billing to Tidalhealth Peninsula Regional, Inc.. 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 (52), Internal Medicine (39) and Cardiovascular Disease (Cardiology) (12). Of these, 50 practice at this address and 103 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tidalhealth Peninsula Regional, Inc. accept?

Health plans from AmeriHealth Caritas Next and Highmark Blue Cross Blue Shield Delaware list Tidalhealth Peninsula Regional, Inc. 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 Peninsula Regional, Inc. was last updated on February 28, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.