NPIMap

Individual provider Active NPI

Edwin Tatoy Castaneda, M.D.

  • Internal Medicine Physician
  • Berlin, MD
National Provider Identifier
1063412385
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO046257 Issued in MD
Practice address
10324 Old Ocean City Blvd
Berlin, MD 21811-1132
Phone
(410) 629-0041
Fax
(410) 629-0544
NPI assigned
Jul 28, 2005
Last updated
Sep 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X DO046257 MD Primary

Addresses

Primary practice location

10324 Old Ocean City Blvd
Berlin, MD 21811-1132

Mailing address

10324 Old Ocean City Blvd
Berlin, MD 21811-1132
Phone (410) 629-0041

Other identifiers 1

IdentifierTypeStateIssuer
317601100MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071129000585 MD Practitioner - Internal Medicine 8729177621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tidalhealth Atlantic IncGroup PAC ID 2365437837, 95 clinicians
Select Rehabilitation, LLCGroup PAC ID 9032020490, 1,935 clinicians
Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

10324 Old Ocean City Blvd
Berlin, MD 21811-1132
Phone (410) 629-0041

11107 Racetrack Rd
Berlin, MD 21811-3279
Phone (410) 208-9761

2600 Compass Rd
Glenview, IL 60026-8001

400 Eastern Shore Dr
Salisbury, MD 21804-5513
Phone (410) 543-8240

6040 Public Landing Rd
Snow Hill, MD 21863-2453
Phone (410) 629-0041

9714 Healthway Dr
Berlin, MD 21811-1154
Phone (410) 641-3340

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.2 of 100Reported as group
Quality
70.92
Promoting interoperability
98
Improvement activities
40
Cost
71.41

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DO046257MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Tidalhealth Specialty Care, LLC CurrentSince Mar 1, 2026 Accepting new patients
Atlantic Immedicare LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: edwincastaneda@agh.allscriptsdirect.net

Organizations & group practices 7

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

Hospital & facility affiliations 12

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1063412385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10324 OLD OCEAN CITY BLVD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111132",
            "telephone_number": "410-629-0041",
            "fax_number": "410-629-0544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10324 OLD OCEAN CITY BLVD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111132",
            "telephone_number": "410-629-0041",
            "fax_number": "410-629-0544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANEDA",
        "first_name": "EDWIN",
        "middle_name": "TATOY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "DO046257",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "317601100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.