Tidalhealth Community Wellness - Medicare Primary Care in Salisbury, MD

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Tidalhealth Community Wellness is a medicare enrolled primary clinic (Family Medicine) in Salisbury, Maryland. The current practice location for Tidalhealth Community Wellness is 100 E Carroll St, Salisbury, Maryland. For appointments, you can reach them via phone at (410) 546-6400. The mailing address for Tidalhealth Community Wellness is 100 E Carroll St, Salisbury, Maryland and phone number is (410) 912-4976.

Tidalhealth Community Wellness is licensed to practice in (license number ). The clinic also participates in the medicare program and its NPI number is 1104453208. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (410) 546-6400.

Contact Information

Tidalhealth Community Wellness
100 E Carroll St
Salisbury
MD 21801-5422
(410) 546-6400
Not Available

Map and Direction


Primary Care Clinic Profile

Full NameTidalhealth Community Wellness
SpecialityFamily Medicine
Location100 E Carroll St, Salisbury, Maryland
Authorized Official Name and PositionWilliam Pelot (CHIEF ADMINISTRATOR OFFICER)
Authorized Official Contact4105437497
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Tidalhealth Community Wellness
100 E Carroll St
Salisbury
MD 21801-5422

Ph: (410) 912-4976		Tidalhealth Community Wellness
100 E Carroll St
Salisbury
MD 21801-5422

Ph: (410) 546-6400

NPI Details:

NPI Number1104453208
Provider Enumeration Date03/26/2020
Last Update Date07/22/2025
Certification Date07/22/2025

Medicare PECOS Information:

Medicare PECOS PAC ID7911320635
Medicare Enrollment IDO20200714000016

Medical Identifiers

Medical identifiers for Tidalhealth Community Wellness such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104453208NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine ()Primary
261QC1500XClinic/center - Community Health ()Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Tidalhealth Community Wellness acts as a billing entity for following providers:
Provider NameElleda C Ziemer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1497742191
PECOS PAC ID: 0345236881
Enrollment ID: I20040507001000
Provider NameBrookellen Rider
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1326036617
PECOS PAC ID: 6608858873
Enrollment ID: I20040603000443
Provider NameMunna Garg
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1902895444
PECOS PAC ID: 6406881341
Enrollment ID: I20050929000610
Provider NameCarrie Dawes
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1104923523
PECOS PAC ID: 2365465796
Enrollment ID: I20060111000567
Provider NameJames B Trumble
Provider TypePractitioner - Emergency Medicine
Provider IdentifiersNPI Number: 1720042831
PECOS PAC ID: 4082626577
Enrollment ID: I20060627000346
Provider NameVijaykumar Karumbunathan
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1174589386
PECOS PAC ID: 6608875703
Enrollment ID: I20061219000480
Provider NameEdwin Castaneda
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1063412385
PECOS PAC ID: 8729177621
Enrollment ID: I20071129000585
Provider NameRonald P Travitz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1841384625
PECOS PAC ID: 1153403621
Enrollment ID: I20080123000739
Provider NameCraig E Johnson
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1306021753
PECOS PAC ID: 6406926260
Enrollment ID: I20080619000668
Provider NameJeffrey Russel Scheirer
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1760593552
PECOS PAC ID: 3476506114
Enrollment ID: I20080718000564
Provider NameDanielle Orr
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1043427081
PECOS PAC ID: 1456425255
Enrollment ID: I20080729000228
Provider NameMairen Baunhofer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548419476
PECOS PAC ID: 3476613142
Enrollment ID: I20081125000700
Provider NameAmy Sood Barshinger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1548455256
PECOS PAC ID: 5991852345
Enrollment ID: I20090422000186
Provider NameMary L Fleury
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1992764815
PECOS PAC ID: 1850449869
Enrollment ID: I20090430000605
Provider NamePaul R Fleury
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1265491286
PECOS PAC ID: 6800924614
Enrollment ID: I20100514000273
Provider NameAmy S Johnson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1245292853
PECOS PAC ID: 7315075140
Enrollment ID: I20100514000323
Provider NameNatalie Tyre
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1073776837
PECOS PAC ID: 5991873028
Enrollment ID: I20100604000754
Provider NameStephen Waters
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1871583807
PECOS PAC ID: 6204967987
Enrollment ID: I20100624000097
Provider NameZareen a Ahmed
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1407039043
PECOS PAC ID: 9032306360
Enrollment ID: I20101213000119
Provider NameJohn a Appiott
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1669440681
PECOS PAC ID: 5496787947
Enrollment ID: I20110120001085
Provider NameMichael Atkins
Provider TypePractitioner - General Practice
Provider IdentifiersNPI Number: 1881651172
PECOS PAC ID: 5890974448
Enrollment ID: I20110127000997
Provider NameLaureen Gallo
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740251305
PECOS PAC ID: 0547234981
Enrollment ID: I20110218000609
Provider NameAnita K Pascucci
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1598903999
PECOS PAC ID: 6608059571
Enrollment ID: I20110330000830
Provider NameChristopher Snyder
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1073512844
PECOS PAC ID: 9537338090
Enrollment ID: I20110818000118
Provider NameAaron Michael Sebach
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225325939
PECOS PAC ID: 5799950960
Enrollment ID: I20111216000415
Provider NameTammy Walbert
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1710986187
PECOS PAC ID: 2264416957
Enrollment ID: I20130724000123
Provider NameRyan Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1760826275
PECOS PAC ID: 7618155409
Enrollment ID: I20130919000112
Provider NameSusanne Curry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1578991766
PECOS PAC ID: 1850520370
Enrollment ID: I20140204000115
Provider NameStephen L Mears
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1265867055
PECOS PAC ID: 8224269949
Enrollment ID: I20140322000112
Provider NameLori M Latona
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1457583759
PECOS PAC ID: 9234364936
Enrollment ID: I20150105000896
Provider NameMelinda Webb
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1225268931
PECOS PAC ID: 2365636768
Enrollment ID: I20150202000231
Provider NameAlison L Diesel
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1871987818
PECOS PAC ID: 7719206549
Enrollment ID: I20150429001570
Provider NameNicole Alu
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1992779136
PECOS PAC ID: 1951369644
Enrollment ID: I20150610002302
Provider NameCynthia Calixte
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1528300100
PECOS PAC ID: 5193025336
Enrollment ID: I20151119002914
Provider NameStephen J Robinson
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1295077519
PECOS PAC ID: 1153620349
Enrollment ID: I20160808000540
Provider NameKeesha L Holden-white
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1750834800
PECOS PAC ID: 9032406285
Enrollment ID: I20161003000733
Provider NameBeverly N Wilson
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1023552817
PECOS PAC ID: 3375828940
Enrollment ID: I20170322000203
Provider NameMelody Evans
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1174050447
PECOS PAC ID: 8123399136
Enrollment ID: I20170919000048
Provider NameSandar Aye
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1942607726
PECOS PAC ID: 9335414952
Enrollment ID: I20171009000721
Provider NameTammy Lynn Donoway
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1902082233
PECOS PAC ID: 1355564667
Enrollment ID: I20171026000865
Provider NameJo Ann Fields
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386612844
PECOS PAC ID: 3678568979
Enrollment ID: I20171213001515
Provider NameOswaldo Nicastro
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1043336613
PECOS PAC ID: 1951426253
Enrollment ID: I20171215001715
Provider NameHeather Kohli-werner
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1720319452
PECOS PAC ID: 1951446954
Enrollment ID: I20180319002698
Provider NameShahabuddin Soherwardi
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1548646383
PECOS PAC ID: 7416246228
Enrollment ID: I20180521001373
Provider NameMark D Weisman
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922073386
PECOS PAC ID: 6709929581
Enrollment ID: I20180801003123
Provider NameJordan Pearson Braniff
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144707720
PECOS PAC ID: 9830440718
Enrollment ID: I20180918000442
Provider NameMary Cherry
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1720560493
PECOS PAC ID: 3870846900
Enrollment ID: I20181019000257
Provider NameDavid M Wanalista
Provider TypePractitioner - Rheumatology
Provider IdentifiersNPI Number: 1497789077
PECOS PAC ID: 8022075589
Enrollment ID: I20181128002796
Provider NameGregory Wilkinson Smith
Provider TypePractitioner - Physician Assistant
Provider IdentifiersNPI Number: 1891267647
PECOS PAC ID: 0840530515
Enrollment ID: I20190314002731
Provider NameAllison Kidney
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1588120497
PECOS PAC ID: 8921349713
Enrollment ID: I20190404000065
Provider NameSufyan Malik
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1356703573
PECOS PAC ID: 5597090100
Enrollment ID: I20190718000090
Provider NameAnastasiya Deem
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1568071462
PECOS PAC ID: 6103242789
Enrollment ID: I20200813000272
Provider NameKathleen E Morris
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871141325
PECOS PAC ID: 4284064411
Enrollment ID: I20200826002645
Provider NameRobert M Paschall
Provider TypePractitioner - Neurology
Provider IdentifiersNPI Number: 1164417499
PECOS PAC ID: 9133200603
Enrollment ID: I20200901000053
Provider NameKunal Agarwal
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1932497773
PECOS PAC ID: 4082846860
Enrollment ID: I20200914001821
Provider NameMakondo Shimukowa
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1730389982
PECOS PAC ID: 6002970332
Enrollment ID: I20210203002852
Provider NameMargo Gill
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1144366816
PECOS PAC ID: 8628132917
Enrollment ID: I20211021001931
Provider NameArfa Ahmad
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1548756372
PECOS PAC ID: 8123377470
Enrollment ID: I20211109002943
Provider NameScott a Sweeney
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1659372811
PECOS PAC ID: 4385678457
Enrollment ID: I20211115001160
Provider NameGeetanjali Johri
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1457762387
PECOS PAC ID: 1951676089
Enrollment ID: I20220110000396
Provider NameJessica a Stoner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1386397230
PECOS PAC ID: 6507251857
Enrollment ID: I20220323001168
Provider NameTreva Stuart
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1053039859
PECOS PAC ID: 1153798020
Enrollment ID: I20221105000079
Provider NameAllison Pusey
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1366163172
PECOS PAC ID: 6305217738
Enrollment ID: I20230124000066
Provider NameKristen Abbott
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1700597382
PECOS PAC ID: 5799143475
Enrollment ID: I20230628001768
Provider NameNatalie Parks
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1124707849
PECOS PAC ID: 5496117178
Enrollment ID: I20230811001585
Provider NameCristian Salgado
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1093337677
PECOS PAC ID: 7416319009
Enrollment ID: I20230814003337
Provider NameDeepa Manimegalan
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1568849693
PECOS PAC ID: 8123371515
Enrollment ID: I20230817003558
Provider NameMegan Tyndall
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1861915779
PECOS PAC ID: 7315391976
Enrollment ID: I20230929003494
Provider NameNeil Basumallik
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1922636588
PECOS PAC ID: 6901251719
Enrollment ID: I20231016000153
Provider NameKirsten Bowie
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1992492755
PECOS PAC ID: 2961859624
Enrollment ID: I20231117000777
Provider NameJason C Coleman
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1578633301
PECOS PAC ID: 0042508830
Enrollment ID: I20231122000053
Provider NameGinger Wille
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396508990
PECOS PAC ID: 3274972971
Enrollment ID: I20240415001035
Provider NameAndrew Jacobs
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1538522487
PECOS PAC ID: 0143561712
Enrollment ID: I20240508002086
Provider NameAndrew Canakis
Provider TypePractitioner - Gastroenterology
Provider IdentifiersNPI Number: 1659875029
PECOS PAC ID: 2062761067
Enrollment ID: I20240605002992
Provider NameShivam Singla
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1508438862
PECOS PAC ID: 5294132916
Enrollment ID: I20240729000630
Provider NameLeah Fetzer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1780432112
PECOS PAC ID: 2567995467
Enrollment ID: I20241030004499
Provider NameMary Darden Mason
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1407685829
PECOS PAC ID: 2365977097
Enrollment ID: I20241119000521
Provider NameKatherine Goth
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1649619701
PECOS PAC ID: 6608174008
Enrollment ID: I20250326002060
Provider NameKarinnet Montero Diaz
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1639811698
PECOS PAC ID: 6002321106
Enrollment ID: I20250716004187
Provider NameEugide Kasongo Othepa
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1639819212
PECOS PAC ID: 1658886676
Enrollment ID: I20250717000589
Provider NameAhmad Nawa
Provider TypePractitioner - Internal Medicine
Provider IdentifiersNPI Number: 1538800297
PECOS PAC ID: 3173024361
Enrollment ID: I20250828005014
Provider NameJane Boylan
Provider TypePractitioner - Registered Dietitian Or Nutrition Professional
Provider IdentifiersNPI Number: 1679382584
PECOS PAC ID: 3971099557
Enrollment ID: I20260102003220
Provider NameHarry Lehman
Provider TypePractitioner - Pediatric Medicine
Provider IdentifiersNPI Number: 1215934245
PECOS PAC ID: 5698059806
Enrollment ID: I20260122002699
Provider NameKeith a Sargent
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1952595506
PECOS PAC ID: 3375613839
Enrollment ID: I20260129004067
Provider NameAli Khalil
Provider TypePractitioner - Psychiatry
Provider IdentifiersNPI Number: 1982371555
PECOS PAC ID: 9830678648
Enrollment ID: I20260211001033
Provider NameKimberly Young-conner
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1093806416
PECOS PAC ID: 5092297333
Enrollment ID: I20260305000828

Reviews and Comments

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.