JAYCIE N LIEBENDORFER APRN, CNP
NPI 1124329206
Nurse Practitioner - Primary Care in Bloomington, IL

Q: What is Jaycie Liebendorfer's NPI number?

The NPI number for Jaycie Liebendorfer is 1124329206. It was assigned to this individual provider in the NPPES registry on November 5, 2010. The provider is also known as Jaycie N Roop.

Q: What is Jaycie Liebendorfer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since November 05, 2010PECOS EnrolledAccepts Medicare Assignment

1701 E COLLEGE AVE, BLOOMINGTON, IL 61704(309) 664-3130(309) 664-3258 Get Directions Write a Review

NPPES record last updated: February 25, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Jaycie N Liebendorfer Aprn, Cnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JAYCIE N LIEBENDORFER APRN, CNP (NPI 1124329206) is an individual primary care provider in Bloomington, Illinois, licensed in Illinois (209008461) and active in the NPI registry since November 2010. She is enrolled in Medicare PECOS, is affiliated with St Joseph Medical Center, and maintains a secondary practice location in Normal.

NPPES Registry Identity

NPI1124329206

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameJAYCIE N LIEBENDORFERCredential: APRN, CNP

Location Address1701 E COLLEGE AVEBloomington, IL 61704-2100

Mailing Address1701 E College AveBloomington, IL 61704-2101 · (309) 664-3130 · Fax (309) 664-3258

Phone(309) 664-3130

Fax(309) 664-3258

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateNovember 5, 2010

Last NPPES UpdateFebruary 25, 2025

NPPES CertifiedFebruary 25, 2025

✔ NPI 1124329206 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in IL · 209008461

Also ListedNurse PractitionerTaxonomy 363L00000X · License 209008461 (IL)

Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X · License 209008461 (IL)

1701 E COLLEGE AVE, Bloomington, IL 61704

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Other Names 1

Former Name (1)Jaycie N Roop

Secondary Practice Location 1

Location 11302 Franklin Ave, Suite 1100Normal, IL 61761-3551 · Phone (309) 268-2727

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jaycie N Liebendorfer Aprn, Cnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890976294

PECOS Enrollment IDI20110217000678

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

291 services97 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

31 services25 patients

Psychiatric diagnostic evaluation with medical services 90792

A psychiatric diagnostic evaluation with medical services is a comprehensive assessment. It includes a detailed examination of your mental health and physical wellbeing, as well as your personal and family history. This evaluation aids in creating an effective treatment plan.

13 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Joseph Medical Center

Acute Care Hospitals · Bloomington, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140162

Location2200 E WashingtonBloomington, IL 61701 · Mc Lean County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MARY CLAIRE BILES PT, MDT

Physical Therapist