Individual provider Active NPI

Jina Libby, DO

  • Sports Medicine (Orthopaedic Surgery) Physician
  • State College, PA
National Provider Identifier
1073173258
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
OS024239 Issued in PA
Practice address
143 Hospital Drive
State College, PA 16803-6706
Phone
(814) 865-3566
Fax
(142) 354-7808
NPI assigned
Jun 19, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 5151013974 MI
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X OS024239 PA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X OS024239 PA Primary

Addresses

Primary practice location

143 Hospital Drive
State College, PA 16803-6706

Mailing address

143 Hospital Drive
State College, PA 16803
Phone (610) 208-4648

Other practice location 1

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 840-8953

Other practice location 2

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-5638

Other practice location 3

200 Jefferson Ave SE Bldg Ste 305
Grand Rapids, MI 49503-4502
Phone (616) 685-6867

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
I20241205002717 PA Practitioner - Physical Medicine and Rehabilitation 0840525168 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Lake Erie Col of Osteo Med at Seton Hill Univ, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Milton S Hershey Medical Center Physicians GroupGroup PAC ID 3870405483, 1,606 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians

Practice addresses (Care Compare)

143 Hospital Dr
Suite 112
State College, PA 16803-6705
Phone (814) 865-3566

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

Hospital & facility affiliations

  • Mount Nittany Medical Center Hospital, State College, PA, CCN 390268
  • Milton S Hershey Medical Center Hospital, Hershey, PA, CCN 390256

Merit-based Incentive Payment System (MIPS)

Final score
79.36 of 100Reported as group
Quality
56.69
Promoting interoperability
100
Improvement activities
40
Cost
74.52

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Milton S Hershey Medical Center Physician Group CurrentSince Oct 7, 2024 Accepting new patients
The Milton S Hershey Medical Center Physicians Group Sports Medicine CurrentSince Oct 7, 2024 Accepting new patients
The Milton S. Hershey Medical Center Physicians Group Past Accepting new patients

Locations

500 University Dr
#410
Hershey, PA 17033
Phone (717) 531-1159

500 University Dr
#A410
Hershey, PA 17033
Phone (717) 531-8131

500 University Dr
Hershey, PA 17033
Phone (717) 531-8181

3100 Schoolhouse Rd
Middletown, PA 17057
Phone (717) 948-5180

143 Hospital Dr
Ste 112
State College, PA 16803
Phone (814) 865-3566

143 Hospital Dr
State College, PA 16803
Phone (814) 235-2480

1850 E Park Ave
Ste 112
State College, PA 16803
Phone (814) 235-4746

Interoperability endpoints

  • Direct secure messaging: jlibby43240@direct.trinity-health.org

Organizations & group practices 3

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 6

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": "1560902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1073173258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 HOSPITAL DRIVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "610-208-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 HOSPITAL DRIVE",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168036706",
            "telephone_number": "814-865-3566",
            "fax_number": "142-354-7808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "235 Wealthy St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495035247",
            "country_code": "US",
            "telephone_number": "616-840-8953",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 University Dr",
            "address_purpose": "LOCATION",
            "city": "Hershey",
            "state": "PA",
            "postal_code": "170332360",
            "country_code": "US",
            "telephone_number": "717-531-5638",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Jefferson Ave SE Bldg Ste 305",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495034502",
            "country_code": "US",
            "telephone_number": "616-685-6867",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIBBY",
        "first_name": "JINA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-19",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5151013974",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "PA",
            "license": "OS024239",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "PA",
            "license": "OS024239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.