Jenny M.S. Mack, AGNP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

310673 Issued in NY

Practice address

161 Carey Rd
Queensbury, NY 12804-7821

Phone

(518) 824-8610

Fax

(518) 824-2390

NPI assigned

Feb 17, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jenny M Sanford Former name

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hudson Headwaters Health NetworkGroup PAC ID 7416861208, 221 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Glens Falls Hospital Hospital, Glens Falls, NY, CCN 330191
• Albany Medical Center Hospital Hospital, Albany, NY, CCN 330013

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Warrensburg, NY
  • NPI 1194738344
  Medicare reassignment Care Compare group NPD
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Fort Edward, NY
  • NPI 1124320247
  NPD
• Hudson Headwaters Health Network

  • Primary Care Clinic/Center
  • Salem, NY
  • NPI 1982417119
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Niskayana, NY
  • NPI 1154973071

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1376577247
  Care Compare affiliation
• Albany Medical Center Hospital

  • Clinical Medical Laboratory
  • Albany, NY
  • NPI 1700204641

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • Radiology Clinic/Center
  • Albany, NY
  • NPI 1811448657

  Hospital

  Care Compare affiliation
• Albany Medical Center Hospital

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1811917461
  Care Compare affiliation
• Glens Falls Hospital Inc

  • General Acute Care Hospital
  • Glens Falls, NY
  • NPI 1871606764
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1645056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1033864152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047880",
            "telephone_number": "518-761-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "161 CAREY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128047821",
            "telephone_number": "518-824-8610",
            "fax_number": "518-824-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "JENNY",
        "middle_name": "M.S.",
        "credential": "AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-17",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "310673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07090760",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNY",
            "last_name": "SANFORD",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Warren Macnaughton, L.AC.
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• Melanie Mahler
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• Adult Health Nurse Practitioner in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Adult Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.