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TIDALHEALTH SPECIALTY CARE, LLC
NPI 1619504735
Clinic/Center - Medical Specialty in Salisbury, MD

Active since March 26, 2020
100 E CARROLL ST, SALISBURY, MD 21801(410) 546-6400(410) 912-4972 Get Directions Write a Review

NPPES record last updated: May 28, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 28, 2026, Feb 28, 2023, Jun 15, 2020 and 3 more (6 updates tracked since 2020).

About Tidalhealth Specialty Care, Llc NPPES

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

TIDALHEALTH SPECIALTY CARE, LLC (NPI 1619504735) is a healthcare organization registered as a medical specialty in Salisbury, Maryland and active in the NPI registry since March 2020. The organization maintains 24 additional practice locations and lists William Pelot, Chief Administrative Officer, as its authorized official.

NPPES Registry Identity

NPI1619504735
Entity TypeOrganization
Primary Taxonomy261QM2500X
Legal Business NameTIDALHEALTH SPECIALTY CARE, LLC
Location Address100 E CARROLL STSalisbury, MD 21801-5422
Mailing Address100 E Carroll StSalisbury, MD 21801-5422 · (410) 546-6400 · Fax (410) 912-4972
Phone(410) 546-6400
Fax(410) 912-4972
Organization SubpartNo
Authorized OfficialWilliam PelotChief Administrative Officer · (410) 543-7497
Enumeration DateMarch 26, 2020
Last NPPES UpdateMay 28, 20266 updates tracked since enumeration
NPPES CertifiedMay 28, 2026
✔ NPI 1619504735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Medical SpecialtyAmbulatory Health Care Facilities
Taxonomy Code261QM2500X
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
100 E CARROLL ST, Salisbury, MD 21801
Open in Google Maps ↗

Secondary Practice Locations 24

Location 11630 Woodbrooke DrSalisbury, MD 21804-8501 · Phone (410) 912-6114 · Fax (410) 912-6115
Location 29733 Healthway DrBerlin, MD 21811-1155 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 310344 Old Ocean City Blvd Ste 1Berlin, MD 21811-1162 · Phone (410) 912-6021 · Fax (410) 912-6022
Location 4560 Riverside Dr Ste 106Salisbury, MD 21801-4700 · Phone (410) 543-7354 · Fax (410) 912-3616
Location 5264 Tilghman RdSalisbury, MD 21804-1921 · Phone (410) 742-7246 · Fax (410) 912-3610
Location 6314 Franklin Ave Ste 402Berlin, MD 21811-1263 · Phone (410) 641-2236 · Fax (410) 641-1693
Location 7560 Riverside Dr Ste A206Salisbury, MD 21801-4704 · Phone (410) 912-5640 · Fax (410) 912-5787
Location 8400 Eastern Shore DrSalisbury, MD 21804-5513 · Phone (410) 749-8906 · Fax (410) 749-4756
Location 9314 Franklin Ave Ste 108Berlin, MD 21811-1236 · Phone (410) 912-6023 · Fax (410) 912-6024
Location 101415 S Division StSalisbury, MD 21804-7291 · Phone (410) 572-8848 · Fax (410) 912-7234
Location 1111105 Cathage RdBerlin, MD 21811-2131 · Phone (410) 912-6330 · Fax (410) 912-4934
Location 12314 Franklin Ave Ste 301Berlin, MD 21811-1238 · Phone (410) 628-0888 · Fax (410) 629-0980
Location 13105 Milford St Ste 605Salisbury, MD 21804-6952 · Phone (410) 334-2227 · Fax (410) 334-3962
Location 1430265 Commerce Dr Unit 104Millsboro, DE 19966-3594 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 15503 Health Services DrSeaford, DE 19973-5782 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 1611107 Cathage Rd Unit 101Ocean Pines, MD 21811-2155 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 171675 Woodbrooke DrSalisbury, MD 21804-8502 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 18600 Glen Ave Ste 203Salisbury, MD 21804-5263 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 19641 S Salisbury BlvdSalisbury, MD 21801-5429 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 201606 Savannah Rd Ste 1Lewes, DE 19958-1656 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 21329 Mullet RunMilford, DE 19963-5373 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 22424 Savannah RdLewes, DE 19958-1462 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 2318941 John J Williams HwyRehoboth Beach, DE 19971-4404 · Phone (410) 749-4154 · Fax (410) 860-9583
Location 24801 Middleford RdSeaford, DE 19973-3636 · Phone (410) 749-4154 · Fax (410) 860-9583

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan, Ambetter Health and more.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 Specialty Care, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

557

Medicare enrollment records show 557 clinicians reassign Medicare billing to Tidalhealth Specialty Care, LLC, which bills Medicare for the services they deliver. Of these, 59 practice at this address and 258 within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 47

Internal Medicine105
Nurse Practitioner105
Cardiovascular Disease (Cardiology)42
Obstetrics/Gynecology26
Pediatric Medicine24
Gastroenterology23
Diagnostic Radiology19
General Surgery18
39 other specialties195

Nearest to this location (20)

See all 557
Nichole Adiletta, MD
Pediatric Medicine
NPI 1164981486
100 E CARROLL ST
Salisbury, MD 21801
(585) 727-8727
✔ PECOSSame address
Yousuf Ahmad, CRNP
Nurse Practitioner
NPI 1184341547
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-7722
✔ PECOS✔ Accepts MedicareSame address
Rudolph Ansah, ACNP
Nurse Practitioner
NPI 1215451901
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOS✔ Accepts MedicareSame address
Deribe Aragaw
Internal Medicine
NPI 1083147516
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOSSame address
Karen Bailey, LCSW-C
Clinical Social Worker
NPI 1407731847
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-4716
✔ PECOSSame address
Shraddha Bhattarai
Internal Medicine
NPI 1790422434
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOS✔ Accepts MedicareSame address
Daniel Cason, M.D.
Diagnostic Radiology
NPI 1386986172
100 E CARROLL ST
Salisbury, MD 21801
(410) 749-1124
✔ PECOS✔ Accepts MedicareSame address
Rajdeep Chana
Cardiovascular Disease (Cardiology)
NPI 1376076034
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOS✔ Accepts MedicareSame address
Simmi Chawla, M.D.
Diagnostic Radiology
NPI 1447274709
100 E CARROLL ST
Salisbury, MD 21801
(410) 677-6656
✔ PECOS✔ Accepts MedicareSame address
Deepak Gupta, MD
Rheumatology
NPI 1811990344
100 E CARROLL ST
Salisbury, MD 21801
(410) 912-6875
✔ PECOS✔ Accepts MedicareSame address
Matthew Karpenko, DO
Hematology/Oncology
NPI 1912118647
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOS✔ Accepts MedicareSame address
Ovais Khalid, M.D.
Psychiatry
NPI 1033345954
100 E CARROLL ST
Salisbury, MD 21801
(800) 749-5191
✔ PECOS✔ Accepts MedicareSame address
Ali Khalil, MD
Psychiatry
NPI 1982371555
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOS✔ Accepts MedicareSame address
Audrey Khoury, MD MPH
Thoracic Surgery
NPI 1982269353
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-1353
✔ PECOS✔ Accepts MedicareSame address
Mounica Koneru, MD
Pediatric Medicine
NPI 1710567409
100 E CARROLL ST
Salisbury, MD 21801
(410) 912-2817
✔ PECOSSame address
Taidine Lopes Bedney, MD
Obstetrics/Gynecology
NPI 1871889550
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-7014
✔ PECOS✔ Accepts MedicareSame address
Pardeep Masuta, M.D.
Pulmonary Disease
NPI 1881077063
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-7536
✔ PECOS✔ Accepts MedicareSame address
Grace Faith Salacup, MD
Pulmonary Disease
NPI 1609438704
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-7722
✔ PECOS✔ Accepts MedicareSame address
Mark Silva, MD
Hospitalist
NPI 1972175784
100 E CARROLL ST
Salisbury, MD 21801
(410) 543-7092
✔ PECOS✔ Accepts MedicareSame address
Rajeev Srivastava, MD
Neuropsychiatry
NPI 1437489770
100 E CARROLL ST
Salisbury, MD 21801
(410) 546-6400
✔ PECOSSame address
See all 557 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 Specialty Care, LLC's NPI number?

The NPI number for Tidalhealth Specialty Care, LLC is 1619504735. It was assigned to this organization in the NPPES registry on March 26, 2020.

Where is Tidalhealth Specialty Care, LLC located?

Tidalhealth Specialty Care, LLC is located at 100 E Carroll St, Salisbury, MD 21801. The listed phone number is (410) 546-6400.

What is Tidalhealth Specialty Care, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Medical Specialty, with taxonomy code 261QM2500X.

Is Tidalhealth Specialty Care, LLC enrolled in Medicare?

Yes. Tidalhealth Specialty Care, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Tidalhealth Specialty Care, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 557 clinicians in 47 Medicare specialties reassign their Medicare billing to Tidalhealth Specialty 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 Internal Medicine (105), Nurse Practitioner (105) and Cardiovascular Disease (Cardiology) (42). Of these, 59 practice at this address and 258 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Tidalhealth Specialty Care, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and AmeriHealth Caritas Next and 1 other insurer list Tidalhealth Specialty 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 Specialty Care, LLC was last updated on May 28, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.