JINA LIBBY (DO) – Sports Medicine (Orthopaedic Surgery) Physician, NPI 1073173258
Sports Medicine (Orthopaedic Surgery) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
565 PHYSICAL MEDICINE AND REHABILITATION in MI
Provider Addresses for JINA LIBBY (DO)
200 JEFFERSON AVE SE BLDG STE 305
GRAND RAPIDS, MI 495034502
Phone: (616) 685-6867
Type: Location
200 Jefferson Ave SE Bldg Ste 305
Grand Rapids, MI 495034502
Phone: (616) 685-6867
Type: Location
235 Wealthy St SE
Grand Rapids, MI 495035247
Phone: (616) 840-8953
Type: Location
500 University Dr
Hershey, PA 170332360
Phone: (717) 531-5638
Type: Location
143 HOSPITAL DRIVE
STATE COLLEGE, PA 16803
Phone: (610) 208-4648
Type: Mailing
Mary Free Bed Rehabilitation Center, 235, Wealthy Street Southeast, Third Ward, Grand Rapids, Kent County, Michigan, 49503, United States
GRAND RAPIDS, MI 495035247
Phone: (616) 840-8953
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $32.
Total Amount is formed as General ($32) + Research ($0) + Ownership ($0) = $32.
Last reported payment date: 2023-04-04 • Largest payer in this snapshot: ABBVIE INC. ($32).
Total Amount
$32
General + Research + Ownership
Payments
2
Total payment records
General Amount
$32
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-04
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $32 |
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: 2024-12-05
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 |
|---|---|---|---|---|
| I20241205002717 | I | Physical Medicine And Rehabilitation | PA | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 49503)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E U R O L O G Y | PA | |
| Family Practice | PA | |
| Emergency Medicine | PA | |
| Family Practice | PA | |
| Family Practice | PA | |
| Orthopedic Surgery | PA | |
| Physician Assistant | PA | |
| Internal Medicine | MA | |
| Physician Assistant | PA | |
| Orthopedic Surgery | PA |
Reviews
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