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TIDALHEALTH SPECIALTY CARE, LLC
NPI 1700699907
Internal Medicine - Pulmonary Disease in Berlin, MD

Active since January 30, 2025
11107 CATHAGE RD UNIT 201, BERLIN, MD 21811(410) 912-6825 Get Directions Write a Review

NPPES record last updated: July 22, 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 1700699907) is a healthcare organization registered as a pulmonary disease in Berlin, Maryland and active in the NPI registry since January 2025. The organization lists William Pelot, Chief Administrative Officer, as its authorized official.

NPPES Registry Identity

NPI1700699907
Entity TypeOrganization
Primary Taxonomy207RP1001X
Legal Business NameTIDALHEALTH SPECIALTY CARE, LLC
Location Address11107 CATHAGE RD UNIT 201Berlin, MD 21811-2156
Mailing AddressPo Box 825461Philadelphia, PA 19182-5461 · (410) 912-6053
Phone(410) 912-6825
Organization SubpartNo
Authorized OfficialWilliam PelotChief Administrative Officer · (410) 543-7497
Enumeration DateJanuary 30, 2025
Last NPPES UpdateJuly 22, 2025
NPPES CertifiedJuly 22, 2025
✔ NPI 1700699907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · Pulmonary DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RP1001X
Definition
An internist who treats diseases of the lungs and airways. The pulmonologist diagnoses and treats cancer, pneumonia, pleurisy, asthma, occupational and environmental diseases, bronchitis, sleep disorders, emphysema and other complex disorders of the lungs.
11107 CATHAGE RD UNIT 201, Berlin, MD 21811
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Other Names 1

Other NameTidalhealth Pulmonary

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

Other Providers at the Same Location NPPES 3

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

JACQUES R CONAWAY M.D.
Internal Medicine (Pulmonary Disease)
11107 CATHAGE RD UNIT 201
BERLIN, MD 21811
Worcester County (410) 912-6825
TIDALHEALTH SPECIALTY CARE, LLC
Internal Medicine (Endocrinology, Diabetes & Metabolism)
11107 CATHAGE RD UNIT 201
BERLIN, MD 21811
Worcester County (410) 912-6023
TIDALHEALTH SPECIALTY CARE, LLC
Internal Medicine (Cardiovascular Disease)
11107 CATHAGE RD UNIT 201
BERLIN, MD 21811
Worcester County (410) 912-6726

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 1700699907. It was assigned to this organization in the NPPES registry on January 30, 2025. The provider is also known as TidalHealth Pulmonary.

Where is Tidalhealth Specialty Care, LLC located?

Tidalhealth Specialty Care, LLC is located at 11107 Cathage Rd Unit 201, Berlin, MD 21811. The listed phone number is (410) 912-6825.

What is Tidalhealth Specialty Care, LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Pulmonary Disease, with taxonomy code 207RP1001X.

When was this NPI record last updated?

The NPPES record for Tidalhealth Specialty 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.