Individual provider Active NPI

Jennifer Sulkow, PA

  • Medical Physician Assistant
  • Albany, NY
National Provider Identifier
1659346427
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4879021 Issued in NY
Practice address
6 Executive Park Dr
Albany, NY 12203-3791
Phone
(518) 482-9111
Fax
(518) 482-6142
NPI assigned
Feb 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4879021 NY Primary

Addresses

Primary practice location

6 Executive Park Dr
Albany, NY 12203-3791

Mailing address

6 Executive Park Dr
Albany, NY 12203-3791
Phone (518) 482-9111

Other identifiers 2

IdentifierTypeStateIssuer
000499324001OtherNYBLUE SHIELD OF NORTHEASTE
4123605OtherNYMOHAWK VALLEY PHYSICIANS

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100813000231 NY Practitioner - Physician Assistant 0345374203 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
87.78 of 100Reported as group
Quality
77.53
Promoting interoperability
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
4879021NYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Medical College CurrentSince Sep 1, 2020 Accepting new patients
Albany Medical College CurrentSince Sep 1, 2020 Accepting new patients

Locations

47 New Scotland Ave
#61
Albany, NY 12208
Phone (518) 262-5791

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1275 Broadway
#106
Menands, NY 12204
Phone (518) 262-9705

6 Executive Park Dr
Stuyvesant Plaza, NY 12203
Phone (518) 482-9111

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1659346427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033791",
            "telephone_number": "518-482-9111",
            "fax_number": "518-482-6142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 EXECUTIVE PARK DR",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122033791",
            "telephone_number": "518-482-9111",
            "fax_number": "518-482-6142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULKOW",
        "first_name": "JENNIFER",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-23",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "4879021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NORTHEASTE",
            "identifier": "000499324001",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MOHAWK VALLEY PHYSICIANS",
            "identifier": "4123605",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, NY

Sources for this page

Verify at the official NPI Registry.