Active NPI
Joshua Rivenbark
- Student in an Organized Health Care Education/Training Program
- Philadelphia, PA
National Provider Identifier
1205455946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology (Internal Medicine) Physician
- License
- MD496149
- Practice address
- 1101 Chestnut St
Philadelphia, PA 19107-3612 - Phone
- (800) 533-3669
- NPI assigned
- Apr 13, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology (Internal Medicine) Physician | 207RH0000X | MD496149 | PA | Primary |
Addresses
Primary practice location
1101 Chestnut St
Philadelphia, PA 19107-3612
Mailing address
1101 Chestnut St
Philadelphia, PA 19107-3612
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1586736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789344000000",
"number": "1205455946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1101 CHESTNUT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1101 CHESTNUT ST",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191073612",
"telephone_number": "800-533-3669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIVENBARK",
"first_name": "JOSHUA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-04-13",
"last_updated": "2026-09-14",
"certification_date": "2026-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207RH0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Hematology",
"state": "PA",
"license": "MD496149",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.