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Tidalhealth Peninsula Regional, Inc.

Organization Active NPI General Acute Care Hospital · Salisbury, MD

NPI 1780689463 · NPPES record last updated Oct 23, 2020

Key facts

NPI
1780689463
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
License
22003 (MD)
Legal business name
TIDALHEALTH PENINSULA REGIONAL, INC.
Practice address
100 E Carroll St
Salisbury, MD 21801-5422
Phone
(410) 546-6400
Fax
(410) 543-7020
NPI assigned
Jun 17, 2005
Organization subpart
No

Authorized official

Name
Steven Leonard
Title
President/C.E.O.
Phone
(410) 546-6400

Owners & managing parties with NPI records 5

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Other NPIs with the same Medicare PAC ID 5

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Practitioners 107

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 107

Affiliated clinicians 935

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 935

Medicare Care Compare: Hospital

Listed as
Tidalhealth Peninsula Regional, Inc CCN 210019
Overall star rating
★★★★☆ 4 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
Active (Provider of Services file)
Emergency services
Yes

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MD

Hospital certification: CCN 210019

Legal name
TIDALHEALTH PENINSULA REGIONAL INC
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 11, 2012
Beds
362
Ownership / control type
Private (not for profit)
Organization structure
Other · Non-profit
Incorporated
Jun 10, 1897 in MD
Enrollment address
100 E Carroll St
Salisbury, MD 21801-5422
Other Hospital Practice Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 26

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Maria Geary Lehman
Individual 		Corporate Director Jan 1, 2020
Mary Christine Dibartolo
Individual 		Corporate Director Jan 1, 2020
Michelle Procino-Wells
Individual 		Corporate Director Jan 1, 2020
Janelle Marie Beiler
Individual 		Corporate Director Jan 1, 2020
Karen Poisker
Individual 		Corporate Director Jan 1, 2020
Ryan McLaughlin
Individual 		Corporate Director
Member, Board of Trustees		 Oct 1, 2013
Steven Leonard
Individual 		Corporate Officer
President/Ceo		 Jan 4, 2018
Timothy L Benning
Individual 		Corporate Director
Member Board of Trustees		 Nov 1, 2013
David Rommel
Individual 		Corporate Director
Member, Board of Trustees		 Nov 1, 2013
Mehmet Diriker
Individual 		Corporate Director Oct 31, 2017
Montgomery Saylor
Individual 		Corporate Director
Vice Chairman, Board of Trustees		 Jan 1, 2007
Julius D Zant
Individual 		Corporate Director
Member, Board of Trustees		 Nov 1, 2017
Martin Neat
Individual 		Corporate Director
Member, Board of Trustees		 Jan 1, 2007
Deborah Abbott
Individual 		Corporate Director Jan 1, 2012
Monica Warsaw
Individual 		W-2 Managing Employee Jul 1, 2021
Andrea Williams
Individual 		Corporate Officer Oct 31, 2018
Benny Stover
Individual 		Corporate Officer
Sr VP Finance/Cfo		 Jan 2, 2026
Herbert Geary
Individual 		Corporate Director
Member, Board of Trustees		 Jan 1, 2012
Mark Thomas Edney
Individual 		Corporate Director Jan 1, 2020
Thomas J Riccio
Individual 		Corporate Director
Member, Board of Trustees		 Jan 1, 2012
Rondall E Allen
Individual 		Corporate Director Jan 1, 2020
Vel Natesan
Individual 		Corporate Director
Member Board of Directors		 Oct 31, 2017
Thomas Coates
Individual 		Corporate Director
Member, Board of Trustees		 Jan 1, 2012
Susan Wilgus Murphy
Individual 		Corporate Director Jan 1, 2020
Simona C Eng
Individual 		Corporate Director
Member Board of Trustees		 Oct 31, 2017
James Webster Hartstein
Individual 		Corporate Director Jan 1, 2020

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040420001571 MD Part B Supplier - Clinic/Group Practice 3072509702 Receives reassigned benefits from 212 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Salisbury, MD; Berlin, MD
O20080527000410 MD Part a Provider - Hospital 3072509702 Practice locations: Salisbury, MD; Snow Hill, MD; Princess Anne, MD; Crisfield, MD; Berlin, MD; Cambridge, MD

National Provider Directory

Locations

30265 Commerce Dr
Ste 106B
Millsboro, DE 19966
Phone (302) 297-2594

9950 N Main St
Berlin, MD 21811
Phone (410) 912-6710

11101 Cathage Rd
Ste 1
Berlin, MD 21811
Phone (410) 912-6106

30434 Mount Vernon Rd
Princess Anne, MD 21853
Phone (410) 543-4705

428 W Market St
Snow Hill, MD 21863
Phone (410) 632-0892

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 22003 MD Yes
Clinical Medical Laboratory 291U00000X 22003 MD

Addresses

Primary practice location

100 E Carroll St
Salisbury, MD 21801-5422

Mailing address

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

Other providers in Salisbury, MD

All providers in Salisbury, MD · General Acute Care Hospital in Maryland

Sources for this page

Verify at the official NPI Registry.