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MARY GRACE JACON FNP
NPI 1699736520
Nurse Practitioner - Family in Rensselaer, NY

Active since March 30, 2006PECOS Enrolled
2 EMPIRE DR, SUITE 100, RENSSELAER, NY 12144(518) 286-4899(518) 286-4859 Get Directions Write a Review

NPPES record last updated: August 22, 2019. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mary Grace Jacon Fnp NPPES

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

MARY GRACE JACON FNP (NPI 1699736520) is an individual family provider in Rensselaer, New York, licensed in New York (330909) and active in the NPI registry since March 2006. She is enrolled in Medicare PECOS and maintains 4 additional practice locations.

NPPES Registry Identity

NPI1699736520
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMARY GRACE JACONCredential: FNP
Location Address2 EMPIRE DR, SUITE 100Rensselaer, NY 12144-5730
Mailing AddressPo Box 689Troy, NY 12181-0689 · (518) 268-5000
Phone(518) 286-4899
Fax(518) 286-4859
Sole ProprietorNo
Enumeration DateMarch 30, 2006
Last NPPES UpdateAugust 22, 2019
✔ NPI 1699736520 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in NY · 330909
2 EMPIRE DR, Rensselaer, NY 12144
Open in Google Maps ↗

Secondary Practice Locations 4

Location 11 Tallow Wood DrClifton Park, NY 12065-2807 · Phone (518) 373-4444
Location 279 Vandenburgh AveTroy, NY 12180-6024 · Phone (518) 286-3000
Location 31300 Massachusetts AveTroy, NY 12180-1628 · Phone (518) 268-5234
Location 4377 Church StSaratoga Springs, NY 12866-8641 · Phone (518) 584-4456

Other Identifiers 1

Medicaid02251747NY

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Grace Jacon Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Mary Grace Jacon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St. Peter's Health Partners Medical Associates, P.C.
3.7 mi
Urology
63 SHAKER RD STE 202, CAPITAL REGION UROLOGY
Albany, NY 12204
  • Reassigned Medicare billing, New York enrollment
  • 742 clinicians in this Medicare group
NPI 1285061721 (518) 434-1283
Samaritan Hospital Of Troy, New York
7.2 mi
General Acute Care Hospital
2215 BURDETT AVE
Troy, NY 12180
  • Reassigned Medicare billing, New York enrollment
  • 725 clinicians in this Medicare group
NPI 1043267727 (518) 271-3300

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12144 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 20

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

MRS. LINDSAY BISHOP RN, FNP
Nurse Practitioner (Family)
2 EMPIRE DR
RENSSELAER, NY 12144
Rensselaer County (518) 286-4960
ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, PC
Family Medicine
2 EMPIRE DR
RENSSELAER, NY 12144
Rensselaer County (518) 286-4960
PAUL BARBAROTTO DO
Family Medicine
2 EMPIRE DR
RENSSELAER, NY 12144
Rensselaer County (518) 286-4899
LORI COSTANZO PT
Physical Therapist
2 EMPIRE DR
RENSSELAER, NY 12144
Rensselaer County (518) 286-4990
DENNIS B CICCHINO PA
Physician Assistant
2 EMPIRE DR
RENSSELAER, NY 12144
Rensselaer County (518) 286-4899
SETON HEALTH SYSTEM
Clinic/Center (Urgent Care)
2 EMPIRE DR, SUITE 101
RENSSELAER, NY 12144
Rensselaer County (518) 286-4960
ORTHOPEDICSNY, LLP
Orthopaedic Surgery
2 EMPIRE DR, SUITE 200
RENSSELAER, NY 12144
Rensselaer County (518) 286-9032
DR. ERIN M WALBORN AU.D.
Audiologist
2 EMPIRE DR, SUITE 204
RENSSELAER, NY 12144
Rensselaer County (518) 283-6111

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Grace Jacon's NPI number?

The NPI number for Mary Grace Jacon is 1699736520. It was assigned to this individual provider in the NPPES registry on March 30, 2006.

Where is Mary Grace Jacon located?

Mary Grace Jacon practices at 2 Empire Dr Suite 100, Rensselaer, NY 12144. The listed phone number is (518) 286-4899.

What is Mary Grace Jacon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Mary Grace Jacon enrolled in Medicare?

Yes. Mary Grace Jacon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Mary Grace Jacon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Grace Jacon reassigns Medicare benefits to 2 organizations: St. Peter's Health Partners Medical Associates, P.C. (Albany, NY) and Samaritan Hospital Of Troy, New York (Troy, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mary Grace Jacon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Grace Jacon was last updated on August 22, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years 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.