OrganizationActive
Tidalhealth Physician Network, Inc.
NPI 1205649514 · Family Medicine Physician · Laurel, DE
Provider details
- NPI number
- 1205649514
- 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
Profile Score
Established profile(55/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
30549 Sussex Hwy
Laurel, DE 19956-3891
Phone: (302) 297-2579
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 824327
Philadelphia, PA 19182-4327
Other names (DBA / former)
- Other name
- Tidalhealth Primary Care Laurel
- Other name
- Tidalhealth Primary Care Laurel
Registry dates
- Enumerated
- 2025-01-30
- Last updated
- 2025-07-22
- Certified
- 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.