KAILI ANNE JACKSON AGNP-C
NPI 1649123639
Nurse Practitioner - Adult Health in Niskayuna, NY

Q: What is Kaili Jackson's NPI number?

The NPI number for Kaili Jackson is 1649123639. It was assigned to this individual provider in the NPPES registry on February 18, 2026.

Q: What is Kaili Jackson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Kaili Jackson was last updated on March 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 18, 2026PECOS EnrolledAccepts Medicare Assignment

2546 BALLTOWN RD STE 200, NISKAYUNA, NY 12309(518) 374-1444(518) 374-0491 Get Directions Write a Review

NPPES record last updated: March 3, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Kaili Anne Jackson Agnp-c NPPES

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

KAILI ANNE JACKSON AGNP-C (NPI 1649123639) is an individual adult health provider in Niskayuna, New York, licensed in New York (F312706-01) and active in the NPI registry since February 2026. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1649123639

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameKAILI ANNE JACKSONCredential: AGNP-C

Location Address2546 BALLTOWN RD STE 200Niskayuna, NY 12309-1079

Mailing Address6 Wellness Way Ste 201Latham, NY 12110-2156 · (518) 782-3700 · Fax (518) 782-3799

Phone(518) 374-1444

Fax(518) 374-0491

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateFebruary 18, 2026

Last NPPES UpdateMarch 3, 2026

NPPES CertifiedMarch 3, 2026

✔ NPI 1649123639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in NY · F312706-01

2546 BALLTOWN RD STE 200, Niskayuna, NY 12309

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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

Kaili Anne Jackson Agnp-c 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 ID8729562467

PECOS Enrollment IDI20260320001924

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12309 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Other Providers at the Same Location NPPES 5

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

MYUNG KANG ALLEN FNP

Nurse Practitioner