Individual provider Active NPI

Elleda Claire Ziemer, DO

  • Family Medicine Physician
  • Salisbury, MD
National Provider Identifier
1497742191
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0061327 Issued in MD
Practice address
100 Power St
Salisbury, MD 21804-6940
Phone
(410) 543-2060
Fax
(410) 543-2051
NPI assigned
Sep 29, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X H0061327 MD Primary

Addresses

Primary practice location

100 Power St
Salisbury, MD 21804-6940

Mailing address

100 Power St
Salisbury, MD 21804-6940
Phone (410) 742-9885

Other identifiers 1

IdentifierTypeStateIssuer
405059200MedicaidMD

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040507001000 MD Practitioner - Family Practice 0345236881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

1639 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone (410) 912-5785

Hospital & facility affiliations

  • Tidalhealth Home Care Home health agency, Salisbury, MD, CCN 217079
  • Homecall Home health agency, Easton, MD, CCN 217066
  • Enhabit Home Health Home health agency, Salisbury, MD, CCN 217157
  • Amedisys Home Health Home health agency, Georgetown, DE, CCN 087034
  • Adoration Home Health Home health agency, Salisbury, MD, CCN 217111
  • Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
  • Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006
  • Atlantic General Hospital Hospital, Berlin, MD, CCN 210061

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
H0061327MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tidalhealth Primary Care, LLC Family Medicine CurrentSince Feb 20, 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

Organizations & group practices 1

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 8

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412553600000",
    "number": "1497742191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 POWER ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046940",
            "telephone_number": "410-742-9885",
            "fax_number": "410-543-2051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 POWER ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046940",
            "telephone_number": "410-543-2060",
            "fax_number": "410-543-2051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIEMER",
        "first_name": "ELLEDA",
        "middle_name": "CLAIRE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-29",
        "last_updated": "2014-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0061327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "405059200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

Verify at the official NPI Registry.