TIDALHEALTH PRIMARY CARE, LLC
NPI 1699594960
Family Medicine in Berlin, MD

Q: What is Tidalhealth Primary Care, LLC's NPI number?

The NPI number for Tidalhealth Primary Care, LLC is 1699594960. It was assigned to this organization in the NPPES registry on October 4, 2024. The provider is also known as TidalHealth Primary Care.

Q: What is Tidalhealth Primary Care, LLC's specialty?

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

Active since October 04, 2024

9950 N MAIN ST, BERLIN, MD 21811(410) 912-6710 Get Directions Write a Review

NPPES record last updated: July 22, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Tidalhealth Primary Care, Llc NPPES

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

TIDALHEALTH PRIMARY CARE, LLC (NPI 1699594960) is a healthcare organization registered as a family medicine in Berlin, Maryland and active in the NPI registry since October 2024. The organization lists William Pelot, Chief Administrator Officer, as its authorized official.

NPPES Registry Identity

NPI1699594960

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameTIDALHEALTH PRIMARY CARE, LLC

Location Address9950 N MAIN STBerlin, MD 21811-1076

Mailing AddressPo Box 825474Philadelphia, PA 19182-5474 · (410) 912-6989 · Fax (410) 912-4972

Phone(410) 912-6710

Organization SubpartNo

Authorized OfficialWilliam PelotChief Administrator Officer · (410) 543-7497

Enumeration DateOctober 4, 2024

Last NPPES UpdateJuly 22, 2025

NPPES CertifiedJuly 22, 2025

✔ NPI 1699594960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ 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.

9950 N MAIN ST, Berlin, MD 21811

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Other Names 1

Other NameTidalhealth Primary Care

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

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 Primary Care, LLC's NPI number?

The NPI number for Tidalhealth Primary Care, LLC is 1699594960. It was assigned to this organization in the NPPES registry on October 4, 2024. The provider is also known as TidalHealth Primary Care.

Where is Tidalhealth Primary Care, LLC located?

Tidalhealth Primary Care, LLC is located at 9950 N Main St, Berlin, MD 21811. The listed phone number is (410) 912-6710.

What is Tidalhealth Primary Care, LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Tidalhealth Primary Care, LLC was last updated on July 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.