Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jennifer Libby, PA-C

Individual provider Physician Assistant · NPI 1497742035

Jennifer Libby, PA-C is a Physician Assistant in Saint Paul, Minnesota. Qualified in 2004, 22 years ago. Practices with Group Health Plan Inc, a 1,633-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
22
Licensed in
MN
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

640 Jackson St
Saint Paul, MN 55101
Phone: (651) 254-4887
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10245 (MN)

Record details

NPI number1497742035
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 29, 2005
Last updated in NPPESOctober 26, 2022
Certification dateOctober 26, 2022
Mailing address8170 33rd Ave S # Ms 21110q, Minneapolis, MN 55425-4516

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Group Health Plan Inc — 1633 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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