Shahabuddin Soherwardi, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

D0084502 Issued in MD

Practice address

100 E Carroll St
Salisbury, MD 21801-5422

Phone

(180) 074-9519

Fax

(800) 749-5191

NPI assigned

Aug 4, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD, DC2 enrollments

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 2

Specialty

Internal Medicine

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Tidalhealth Primary Care LLCGroup PAC ID 7911320635, 63 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tidalhealth Peninsula Regional, Inc Hospital, Salisbury, MD, CCN 210019
• Atlantic General Hospital Hospital, Berlin, MD, CCN 210061
• Tidalhealth Nanticoke, Inc. Hospital, Seaford, DE, CCN 080006

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Eastern Shore Internist LLC

  • Internal Medicine Physician
  • Salisbury, MD
  • NPI 1508682576
  Medicare reassignment NPD Authorized official
• Synergy Medical Group LLC

  • Internal Medicine Physician
  • Lutherville, MD
  • NPI 1912736901
  Medicare reassignment Care Compare group NPD
• Tidalhealth Primary Care, LLC

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1104453208
  Medicare reassignment Care Compare group NPD
• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Atlantic General Hospital Corporation

  dba Atlantic General Health System

  • Family Medicine Physician
  • Berlin, MD
  • NPI 1871582171

  Internal Medicine

  Medicare reassignment NPD
• Tidalhealth Peninsula Regional, Inc.

  • Family Medicine Physician
  • Salisbury, MD
  • NPI 1184832040

  Internal Medicine

  Medicare reassignment NPD
• Synergy Medical Group LLC

  • Vascular Surgery Physician
  • Timonium, MD
  • NPI 1679363089

  DC

  Medicare reassignment
• Atlantic General Hospital Corp

  dba Atlantic General Health Systems WOC Imaging Center

  • Radiology Clinic/Center
  • Ocean City, MD
  • NPI 1043756232
  NPD
• Synergy Medical Group LLC

  • Nephrology Physician
  • Timonium, MD
  • NPI 1144902776

  Internal Medicine

  NPD
• Synergy Medical Group LLC

  • Nephrology Physician
  • Hagerstown, MD
  • NPI 1881564979

  Internal Medicine

  NPD
• Tidalhealth Atlantic, Inc.

  dba AGHRx RediScripts Ocean Pines

  • Community/Retail Pharmacy
  • Berlin, MD
  • NPI 1740963859
  NPD
• Tidalhealth Peninsula Regional, Inc.

  dba TidalHealth Specialty Pharmacy

  • Community/Retail Pharmacy
  • Salisbury, MD
  • NPI 1871031559
  NPD

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

• Tidalhealth Atlantic, Inc

  dba Atlantic General Hospital Corp

  • General Acute Care Hospital
  • Berlin, MD
  • NPI 1053309120
  Care Compare affiliation
• Tidalhealth Peninsula Regional, Inc.

  • General Acute Care Hospital
  • Salisbury, MD
  • NPI 1780689463
  Care Compare affiliation
• Tidalhealth Nanticoke, Inc

  • General Acute Care Hospital
  • Seaford, DE
  • NPI 1245214477
  Care Compare affiliation

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

{
    "created_epoch": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729296000000",
    "number": "1548646383",
    "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": "800-749-5191",
            "fax_number": "410-630-7685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "180-074-9519",
            "fax_number": "800-749-5191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200600001",
            "country_code": "US",
            "telephone_number": "202-865-1920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOHERWARDI",
        "first_name": "SHAHABUDDIN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-04",
        "last_updated": "2024-10-19",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V4501",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "DC",
            "license": "MTL002959",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0084502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD LICENSE",
            "identifier": "D0084502",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie Nicole Snively
• Madeline Renee Snow
• John Matthew Snowden, M.D.
• Christopher S. Snyder, D.O.
• Richard W. Snyder, D.D.S.
• Cassidy Bret Soistman, LCSW-C
• Lori A Soley, CRNP MS
• Sophia Sonen, LCADC
• Southside Medical Care LLC
• Michael Spack, PA

• Internal Medicine Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.