Individual provider Active NPI

Juan Lopez Tiboni, MD

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1689247546
Registry record updated Jun 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD487427 Issued in PA
Practice address
800 Spruce St
Philadelphia, PA 19107-6130
Phone
(215) 327-6202
NPI assigned
Jul 20, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD487427 PA Primary

Addresses

Primary practice location

800 Spruce St
Philadelphia, PA 19107-6130

Mailing address

800 Spruce St
Philadelphia, PA 19107-6192

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250424000644 PA Practitioner - Internal Medicine 7113443078 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

800 Spruce St FL 1 Pine W
Hospital Medicine Pah
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD487427PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Apr 24, 2025 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Internal Medicine CurrentSince Apr 24, 2025 Accepting new patients
The Pennsylvania Hospital of the University of Pennsylvania Health Sys Past Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst Internal Medicine Past Accepting new patients

Locations

800 Spruce St
Fl 1
Philadelphia, PA 19107
Phone (215) 829-5873

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 4

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": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1689247546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-327-6202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ TIBONI",
        "first_name": "JUAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-20",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD487427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.