Individual provider Active NPI

Treva Stuart, NP

  • Adult Health Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1053039859
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
R161124 Issued in MD
Practice address
1639 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone
(410) 912-5785
NPI assigned
Aug 17, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R161124 MD Primary

Addresses

Primary practice location

1639 Woodbrooke Dr
Salisbury, MD 21804-8502

Mailing address

100 E Carroll St
Salisbury, MD 21801-5422
Phone (410) 546-6400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221105000079 MD Practitioner - Nurse Practitioner 1153798020 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

100 E Carroll St
Salisbury, MD 21801-5422

400 Eastern Shore Dr
Salisbury, MD 21804-5513

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R161124MDMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC CurrentSince Oct 1, 2022 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Dec 19, 2023 Accepting new patients

Locations

1639 Woodbrooke Dr
Salisbury, MD 21804
Phone (410) 543-7475

400 Eastern Shore Dr
Salisbury, MD 21804
Phone (410) 543-2255

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

145 E Carroll St
Salisbury, MD 21801
Phone (410) 546-6400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1053039859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1639 WOODBROOKE DR",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218048502",
            "telephone_number": "410-912-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "TREVA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-17",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R161124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.