Individual provider Active NPI

Kwan Thanaporn Rivlin, M.D.

  • Internal Medicine Physician
  • Voorhees, NJ
National Provider Identifier
1427396209
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA09669000 Issued in NJ
Practice address
200 Bowman Dr Ste E385
Voorhees, NJ 08043-9638
Phone
(856) 840-4534
NPI assigned
Jan 29, 2013
Last updated
Apr 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 255025 MA
Hospitalist Physician 208M00000X 25MA09669000 NJ
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 25MA09669000 NJ Primary

Addresses

Primary practice location

200 Bowman Dr Ste E385
Voorhees, NJ 08043-9638

Mailing address

200 Bowman Drive
Suitee385
Moorestown, NJ 08043
Phone (856) 840-4534

Other practice location 1

218 Sunset Rd Fl 5
Willingboro, NJ 08046-1110
Phone (609) 835-3056

Other practice location 2

90 Brick Rd Fl 3
Marlton, NJ 08053-2177
Phone (856) 355-6730

Other practice location 3

175 Madison Ave Fl 1
Mount Holly, NJ 08060-2099
Phone (609) 914-6000

Other practice location 4

100 Bowman Dr Lowr Level1
Voorhees, NJ 08043-9612
Phone (856) 247-3000

Other practice location 5

1600 Haddon Ave Fl 6 Main
Camden, NJ 08103-3101
Phone (856) 757-3500

Other identifiers 1

IdentifierTypeStateIssuer
0569321MedicaidNJ

Other names 1

  • Thanaporn Rivlin Former name

Electronic endpoints 6

TypeEndpointUseAffiliation
Direct Messaging Address krivlin18886@directvirtua.org
Direct Messaging Address krivlin18886@directvirtua.org
Direct Messaging Address krivlin18886@directvirtua.org
Direct Messaging Address krivlin18886@directvirtua.org
Direct Messaging Address krivlin18886@directvirtua.org
Direct Messaging Address krivlin18886@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20160912000843 NJ Practitioner - Internal Medicine 3870728280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

100 Bowman Dr
Voorhees, NJ 08043-9612
Phone (856) 247-3328

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Internal Medicine CurrentSince Apr 20, 2025 Accepting new patients
Advocare, LLC Internal Medicine CurrentSince Nov 21, 2017 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2016 Accepting new patients
Virtua Medical Group, PA CurrentSince Aug 1, 2016 Accepting new patients
Advocare , LLC Internal Medicine CurrentSince Nov 21, 2017 Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

1600 Haddon Ave
Fl 6
Camden, NJ 08103
Phone (856) 247-2160

132 Grove St
Ste A
Haddonfield, NJ 08033
Phone (856) 354-2211

90 Brick Rd
Marlton, NJ 08053
Phone (856) 355-6040

90 Brick Rd
Fl 3
Marlton, NJ 08053
Phone (856) 247-2160

175 Madison Ave
Fl 1
Mount Holly, NJ 08060
Phone (609) 914-6000

7000 Atrium Way
Ste 6
Mount Laurel, NJ 08054
Phone (856) 206-4500

100 Bowman Dr
Voorhees, NJ 08043
Phone (856) 247-3000

100 Bowman Dr
Fl 1
Voorhees, NJ 08043
Phone (856) 247-2645

100 Bowman Dr
Lowr
Voorhees, NJ 08043
Phone (856) 247-3000

200 Bowman Dr
Ste 385
Voorhees, NJ 08043
Phone (856) 840-4534

200 Bowman Dr
Ste E385
Voorhees, NJ 08043
Phone (856) 247-7220

218 Sunset Rd
Fl 5
Willingboro, NJ 08046
Phone (609) 444-0359

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1427396209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DRIVE",
            "address_2": "SUITEE385",
            "city": "MOORESTOWN",
            "state": "NJ",
            "postal_code": "08043",
            "telephone_number": "856-840-4534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BOWMAN DR STE E385",
            "city": "VOORHEES",
            "state": "NJ",
            "postal_code": "080439638",
            "telephone_number": "856-840-4534"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "218 Sunset Rd Fl 5",
            "address_purpose": "LOCATION",
            "city": "Willingboro",
            "state": "NJ",
            "postal_code": "080461110",
            "country_code": "US",
            "telephone_number": "609-835-3056",
            "fax_number": "609-835-5741",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "90 Brick Rd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Marlton",
            "state": "NJ",
            "postal_code": "080532177",
            "country_code": "US",
            "telephone_number": "856-355-6730",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "175 Madison Ave Fl 1",
            "address_purpose": "LOCATION",
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            "state": "NJ",
            "postal_code": "080602099",
            "country_code": "US",
            "telephone_number": "609-914-6000",
            "fax_number": "609-914-6182",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Bowman Dr Lowr Level1",
            "address_purpose": "LOCATION",
            "city": "Voorhees",
            "state": "NJ",
            "postal_code": "080439612",
            "country_code": "US",
            "telephone_number": "856-247-3000",
            "fax_number": "856-247-2597",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Haddon Ave Fl 6 Main",
            "address_purpose": "LOCATION",
            "city": "Camden",
            "state": "NJ",
            "postal_code": "081033101",
            "country_code": "US",
            "telephone_number": "856-757-3500",
            "fax_number": "856-365-4088",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RIVLIN",
        "first_name": "KWAN",
        "middle_name": "THANAPORN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "255025",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NJ",
            "license": "25MA09669000",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA09669000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0569321",
            "state": "NJ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "1600 Haddon Ave Fl 6 Main",
            "city": "Camden",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "081033101",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "90 Brick Rd Fl 3",
            "city": "Marlton",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080532177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "200 Bowman Dr Ste E385",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "218 Sunset Rd Fl 5",
            "city": "Willingboro",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080461110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "100 Bowman Dr Lowr Level1",
            "city": "Voorhees",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080439612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "krivlin18886@directvirtua.org",
            "affiliation": "N",
            "address_1": "175 Madison Ave Fl 1",
            "city": "Mount Holly",
            "state": "NJ",
            "country_code": "US",
            "postal_code": "080602099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "THANAPORN",
            "last_name": "RIVLIN",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Voorhees, NJ

Sources for this page

Verify at the official NPI Registry.