JAYCIE N LIEBENDORFER (APRN, CNP) – Primary Care Nurse Practitioner, NPI 1124329206
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for JAYCIE N LIEBENDORFER (APRN, CNP)
1302 FRANKLIN AVE
SUITE 1100
NORMAL, IL 617613551
Phone: (309) 268-2727
Type: Mailing
1302 Franklin Ave
Suite 1100
Normal, IL 617613551
Phone: (309) 268-2727
Type: Location
1701 E COLLEGE AVE
BLOOMINGTON, IL 617042101
Phone: (309) 664-3130
Fax: (309) 664-3258
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 5 Open Payments records for all available years, with a total value of $385.
Total Amount is formed as General ($385) + Research ($0) + Ownership ($0) = $385.
Last reported payment date: 2024-06-19 • Largest payer in this snapshot: Neurocrine BioSciences Inc. ($111).
Total Amount
$385
General + Research + Ownership
Payments
5
Total payment records
General Amount
$385
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-06-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Neurocrine BioSciences Inc. | $111 |
| ABBVIE INC. | $110 |
| Corium, LLC | $62 |
| Teva Pharmaceuticals USA, Inc. | $60 |
| ITI, Inc. | $42 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-02-17
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110217000678 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 296 | 80 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 11 | 11 | $0 |
Insurance plans in this area (ZIP 61761)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | IL | |
| - | IL | |
| - | TN | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| - | IL | |
| Physician Assistant | MO | |
| - | IL |
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