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TIDALHEALTH SPECIALTY CARE, LLC
NPI 1619839776
Internal Medicine - Endocrinology, Diabetes & Metabolism in Berlin, MD

Active since November 26, 2025
10614 RACETRACK RD UNIT 5, BERLIN, MD 21811(410) 629-6800 Get Directions Write a Review

NPPES record last updated: November 26, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tidalhealth Specialty Care, Llc NPPES

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

TIDALHEALTH SPECIALTY CARE, LLC (NPI 1619839776) is a healthcare organization registered as an endocrinology, diabetes & metabolism in Berlin, Maryland and active in the NPI registry since November 2025. The organization lists Sloan Trammell, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1619839776
Entity TypeOrganization
Primary Taxonomy207RE0101X
Legal Business NameTIDALHEALTH SPECIALTY CARE, LLC
Location Address10614 RACETRACK RD UNIT 5Berlin, MD 21811-3383
Mailing AddressPo Box 825461Philadelphia, PA 19182-5461
Phone(410) 629-6800
Organization SubpartNo
Authorized OfficialSloan TrammellCredentialing Manager · (410) 912-6989
Enumeration DateNovember 26, 2025
NPPES CertifiedNovember 26, 2025
✔ NPI 1619839776 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Definition
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.
10614 RACETRACK RD UNIT 5, Berlin, MD 21811
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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

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TIDALHEALTH SPECIALTY CARE, LLC
Internal Medicine (Pulmonary Disease)
10614 RACETRACK RD UNIT 5
BERLIN, MD 21811
Worcester County (410) 629-1450
DR. EUGIDE KASONGO OTHEPA MD
Family Medicine
10614 RACETRACK RD UNIT 5
BERLIN, MD 21811
Worcester County (410) 208-9761
TIDALHEALTH SPECIALTY CARE, LLC
Internal Medicine (Gastroenterology)
10614 RACETRACK RD UNIT 5
BERLIN, MD 21811
Worcester County (410) 629-1450
TIDALHEALTH PRIMARY CARE, LLC
Family Medicine
10614 RACETRACK RD UNIT 5
BERLIN, MD 21811
Worcester County (410) 208-9761
ATLANTIC GENERAL HOSPITAL CORPORATION
Family Medicine
10614 RACETRACK RD UNIT 5
BERLIN, MD 21811
Worcester County (410) 208-9761

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 1619839776. It was assigned to this organization in the NPPES registry on November 26, 2025.

Where is Tidalhealth Specialty Care, LLC located?

Tidalhealth Specialty Care, LLC is located at 10614 Racetrack Rd Unit 5, Berlin, MD 21811. The listed phone number is (410) 629-6800.

What is Tidalhealth Specialty Care, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

When was this NPI record last updated?

The NPPES record for Tidalhealth Specialty Care, LLC was last updated on November 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.