Tidalhealth Primary Care, LLC
NPI 1104453208 · Family Medicine Physician · Salisbury, MD
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Tidalhealth Primary Care, LLC is a Family Medicine Physician organization in Salisbury, MD (NPI 1104453208).
Provider details
- NPI number
- 1104453208
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Pelot, Chief Administrator Officer(410) 543-7497
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Community Health Clinic/Center261QC1500X
Ambulatory Health Care Facilities
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
10 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Tidalhealth Community Wellness
Additional practice locations (9)
- 30265 Commerce DrSuite 206Millsboro, DE 19966-3595Phone: (302) 732-8400Fax: (302) 934-6705
- 9950 N Main StBerlin, MD 21811-1076Phone: (410) 912-6710
- 201 Hall HwyCrisfield, MD 21817-1237Phone: (410) 968-1801Fax: (410) 968-1015
- 11101 Cathage RdOcean Pines, MD 21811-2115Phone: (410) 912-6104Fax: (410) 208-1872
- 305 10th St Ste 101Pocomoke City, MD 21851-1607Phone: (410) 912-4950
- 145 E Carroll StSalisbury, MD 21801-5454Phone: (410) 912-5785Fax: (410) 912-3616
- 1639 Woodbrooke DrSalisbury, MD 21804-8502Phone: (410) 912-5785
- 100 E Carroll StSalisbury, MD 21801-5422Phone: (410) 912-6400
- 428 W Market St
Registry dates
- Enumerated
- 2020-03-26
- Last updated
- 2025-07-22
- Certified
- 2025-07-22
Frequently asked questions
- What is Tidalhealth Primary Care, LLC's NPI number?
- Tidalhealth Primary Care, LLC's National Provider Identifier (NPI) is 1104453208, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Tidalhealth Primary Care, LLC?
- Tidalhealth Primary Care, LLC is classified in the NPPES registry as Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Tidalhealth Primary Care, LLC located?
- Tidalhealth Primary Care, LLC's practice location on file with NPPES is 100 E Carroll St, Salisbury, MD 21801-5422.
- What is Tidalhealth Primary Care, LLC's phone number?
- The practice phone number listed in the NPPES registry for Tidalhealth Primary Care, LLC is (410) 546-6400.
- Does Tidalhealth Primary Care, LLC accept Medicare?
- Tidalhealth Primary Care, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Tidalhealth Primary Care, LLC?
- The authorized official listed on Tidalhealth Primary Care, LLC's NPPES record is William Pelot, Chief Administrator Officer. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Tidalhealth Primary Care, LLC's NPI active?
- Yes — Tidalhealth Primary Care, LLC's NPI (1104453208) is active in the NPPES registry as of the last update on 2025-07-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.