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

Kaili Anne Jackson, AGNP-C

Individual provider Adult Health Nurse Practitioner · NPI 1649123639

Kaili Anne Jackson, AGNP-C is a Nurse Practitioner in Niskayuna, New York. Qualified in 2025, 1 year ago. Practices with Community Care Physicians PLLC, a 364-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
1
Licensed in
NY
In the registry since
2026

Practice location Address checks out

2546 Balltown Rd Ste 200
Niskayuna, NY 12309-1079
Phone: (518) 374-1444
Fax: (518) 374-0491
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence F312706-01 (NY)

Record details

NPI number1649123639
Entity typeIndividual (Type 1)
GenderFemale
Credentials AGNP-C
Sole proprietorNo
NPI enumeratedFebruary 18, 2026
Last updated in NPPESMarch 3, 2026
Certification dateMarch 3, 2026

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Community Care Physicians Pllc — 364 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Niskayuna