TIDALHEALTH SPECIALTY CARE, LLC
NPI 1245855196
Internal Medicine - Endocrinology, Diabetes & Metabolism in Salisbury, MD
NPI Status: Active since June 16, 2020
Contact Information
1639 WOODBROOKE DR
SALISBURY, MD
ZIP 21804
Phone: (410) 912-7234
Fax: (410) 572-6890
- Organization
- Internal Medicine
- Endocrinology, Diabetes & Metabolism
- CLIA Number: 21D0221165
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 01-27-2027
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 endocrinology, diabetes & metabolism . The healthcare provider is registered in the NPI registry with number 1245855196 assigned on June 2020. The practitioner's primary taxonomy code is 207RE0101X. 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
- NPI
- 1245855196
- Provider Legal Name
- TIDALHEALTH SPECIALTY CARE, LLC
- Other Organization Name
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1639 WOODBROOKE DR SALISBURY, MD 21804
- Location Phone
- (410) 912-7234
- Location Fax
- (410) 572-6890
- 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 - 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 Endocrinology, Diabetes & Metabolism
- Taxonomy Code
- 207RE0101X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Group Taxonomy 193400000X 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.
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
- 21D0221165
- Facility Type
- Physician Office
- Certificate Effective Date
- January 28, 2025
- Certificate Expiration Date
- January 27, 2027
- Laboratory Director
- RENE L. DESMARAIS
- 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 1245855196, 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 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 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.
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 64 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 7 providers are registered at the same or a nearby location.
SALISBURY, MD 21804
SALISBURY, MD 21804
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1245855196, enumerated as an "organization" on June 16, 2020.
The provider is located at 1639 WOODBROOKE DR SALISBURY, MD 21804 and the phone number is (410) 912-7234.
Internal Medicine with taxonomy code 207RE0101X and a focus in Endocrinology, Diabetes & Metabolism.
