Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Ellis

Individual provider Physician Assistant · NPI 1922403450

Charles Ellis is a Physician Assistant in Salisbury, Maryland. Qualified in 2014, 12 years ago. Practices with Tidalhealth Specialty Care LLC, a 366-clinician group and accepts Medicare assignment. Licensed in Maryland.

Years since qualifying
12
Licensed in
MD
In the registry since
2014
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Practice location Address checks out

1675 Woodbrooke Dr
Salisbury, MD 21804-8502
Phone: (410) 749-4154
Fax: (410) 860-9583
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence C05576 (MD)

Record details

NPI number1922403450
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedOctober 27, 2014
Last updated in NPPESAugust 15, 2025
Certification dateAugust 15, 2025
Mailing addressPo Box 69709, Baltimore, MD 21264-9709

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Tidalhealth Specialty Care Llc — 366 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Salisbury