NPIMap

Individual provider Active NPI

Jay J Libys, MD

  • Cardiovascular Disease Physician
  • Gulfport, MS
National Provider Identifier
1649380536
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
14619 Issued in MS
Practice address
14055 Seaway Road
Gulfport, MS 39503
Phone
(228) 868-5555
Fax
(228) 574-2001
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 14619 MS Primary

Addresses

Primary practice location

14055 Seaway Road
Gulfport, MS 39503

Mailing address

14055 Seaway Road
Gulfport, MS 39503
Phone (228) 868-5555

Other identifiers 1

IdentifierTypeStateIssuer
00115535MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051215000654 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 7618998998 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
West Virginia University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4500 13TH St
Gulfport, MS 39501-2515
Phone (228) 822-6132

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jay J Libys MD PA Cardiovascular Disease CurrentSince Jun 1, 2022 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

4500 13th St
#P
Gulfport, MS 39501
Phone (228) 865-3451

4500 13th St
Gulfport, MS 39501
Phone (228) 236-3872

Interoperability endpoints

  • Direct secure messaging: jlibys@direct.mhg.com

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 and National Provider Directory roles.

Hospital & facility affiliations 62

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 62

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1649380536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14055 SEAWAY ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39503",
            "telephone_number": "228-868-5555",
            "fax_number": "228-574-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14055 SEAWAY ROAD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39503",
            "telephone_number": "228-868-5555",
            "fax_number": "228-574-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBYS",
        "first_name": "JAY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-07-21",
        "certification_date": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "14619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00115535",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.