Tidalhealth Physician Network, Inc.
Organization Active NPI Family Medicine Physician · Seaford, DE
NPI 1467534636 · NPPES record last updated Jul 22, 2025
Key facts
- NPI
- 1467534636
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- TIDALHEALTH PHYSICIAN NETWORK, INC.
- Practice address
- 801 Middleford Rd
Seaford, DE 19973-3636 - Phone
- (302) 629-5217
- NPI assigned
- Oct 19, 2006
- Organization subpart
- No
Authorized official
- Name
- William Pelot
- Title
- Chief Administrator Officer
- Phone
- (410) 543-7497
Practitioners 210
-
Raheel Awan, MD
-
Linda Anne Barriocanal, A.R.N.P.
-
Ian Michael Baxter, D.O.
-
Jessica W Baxter, FNP
-
David Cohen, M.D.
-
Andrew Curley, M.D.
-
Henry Degroot III, M.D.
-
Mary Dickerson, CRNP
-
Sean Michael Forsyth, FNP
-
Khalil F Gorgui, M.D.
-
Abha Gupta, MD
-
Stuart Kyle Hensley, FNP-C
-
Danniell Kristen Hicks, FNP-C
-
Joseph Francis Karnish, D. O.
-
Nourhan Arafa Kika, M.D.
-
Joseph Hill Kim, D.O.
-
Cynthia S Knight, APRN
-
Faith Michelle Lauer, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DE, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041119000090 | DE | Part B Supplier - Clinic/Group Practice | 7315901253 |
Receives reassigned benefits from 186 practitioners Practice locations: Bridgeville, DE; Delmar, DE; Georgetown, DE; Seaford, DE |
| O20070126000314 | MD | Part B Supplier - Clinic/Group Practice | 7315901253 |
Receives reassigned benefits from 19 practitioners Practice locations: Berlin, MD; Federalsburg, MD |
National Provider Directory
Locations (25 of 26)
18119 Sussex Hwy
Unit 1
Bridgeville, DE 19933
Phone (302) 228-5128
9111 Antique Aly
Unit 101
Bridgeville, DE 19933
9111 Antique Aly
Bridgeville, DE 19933
Phone (302) 337-8789
8 E Grove St
Delmar, DE 19940
Phone (302) 846-0618
38552 Sussex Hwy
Unit 1
Delmar, DE 19940
505 W Market St
Ste 140
Georgetown, DE 19947
Phone (302) 856-2360
505 W Market St
#B
Georgetown, DE 19947
30549 Sussex Hwy
Laurel, DE 19956
Phone (302) 715-5214
116 E Front St
Laurel, DE 19956
Phone (302) 875-2127
28538 DuPont Blvd
Unit 2
Millsboro, DE 19966
28538 DuPont Blvd
Unit 1
Millsboro, DE 19966
Phone (302) 829-3294
1000 Health Services Dr
Seaford, DE 19973
Phone (302) 297-2506
1309 Bridgeville Hwy
#1
Seaford, DE 19973
Phone (302) 629-3923
201 Health Services Dr
Seaford, DE 19973
Phone (302) 297-2412
1330 Middleford Rd
Seaford, DE 19973
Phone (302) 536-1395
121 S Front St
Seaford, DE 19973
Phone (302) 629-4299
200 Rawlins Dr
Seaford, DE 19973
Phone (302) 536-5415
1320 Middleford Rd
Seaford, DE 19973
Phone (302) 629-3044
1350 Middleford Rd
Ste 502
Seaford, DE 19973
Phone (302) 628-8300
8472 Herring Run Rd
#2
Seaford, DE 19973
Phone (302) 629-8977
23094 Atlanta Rd
Seaford, DE 19973
Phone (302) 629-5766
613 High St
Seaford, DE 19973
Phone (302) 629-3923
200 Health Services Dr
Seaford, DE 19973
Phone (302) 297-2412
1309 Bridgeville Hwy
Ste 9
Seaford, DE 19973
3304 Hayman Dr
Federalsburg, MD 21632
Phone (410) 754-2400
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
801 Middleford Rd
Seaford, DE 19973-3636
Mailing address
801 Middleford Rd
Seaford, DE 19973-3636
Phone (302) 629-6611
Other names
- Mid-Sussex Medical Center Inc
Other providers in Seaford, DE
- Tidalhealth Nanticoke, Inc
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
- Tidalhealth Physician Network, Inc.
All providers in Seaford, DE · Family Medicine Physician in Delaware
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 22, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.