Individual provider Active NPI

Jennifer Nicole Selby, RN, AGACNP

  • Acute Care Nurse Practitioner
  • Kingston, NY
National Provider Identifier
1760905756
Registry record updated Aug 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
431159 Issued in NY
Practice address
105 Marys Ave
Kingston, NY 12401-5829
Phone
(845) 338-2500
NPI assigned
Jul 20, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 14790 CT
Acute Care Nurse Practitioner 363LA2100X 431159 NY Primary

Addresses

Primary practice location

105 Marys Ave
Kingston, NY 12401-5829

Mailing address

45 Reade PL
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

Other practice location 1

6511 Spring Brook Ave
Rhinebeck, NY 12572-3709
Phone (845) 876-3001

Other practice location 2

50 Hospital Hill Rd
Sharon, CT 06069-2092
Phone (860) 364-4000

Other practice location 3

45 Reade Pl
Poughkeepsie, NY 12601-3947
Phone (845) 454-8500

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
I20170817003151 NY Practitioner - Nurse Practitioner 4789956277 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
14790CTMDClinical Social Worker
431159NYMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Westchester Medical Center Advanced Physician Services PC CurrentSince Jan 6, 2020 Accepting new patients
Westchester Medical Center Advanced Physician Services, PC CurrentSince Jan 6, 2020 Accepting new patients

Locations

105 Marys Ave
Kingston, NY 12401
Phone (845) 334-3080

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

45 Reade Pl
Poughkeepsie, NY 12601
Phone (845) 331-3131

6511 Spring Brook Ave
Rhinebeck, NY 12572
Phone (845) 871-3368

95 Grasslands Rd
Valhalla, NY 10595
Phone (914) 493-2961

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989

Organizations & group practices 2

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": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756339200000",
    "number": "1760905756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-454-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MARYS AVE",
            "city": "KINGSTON",
            "state": "NY",
            "postal_code": "124015829",
            "telephone_number": "845-338-2500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6511 Spring Brook Ave",
            "address_purpose": "LOCATION",
            "city": "Rhinebeck",
            "state": "NY",
            "postal_code": "125723709",
            "country_code": "US",
            "telephone_number": "845-876-3001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "50 Hospital Hill Rd",
            "address_purpose": "LOCATION",
            "city": "Sharon",
            "state": "CT",
            "postal_code": "060692092",
            "country_code": "US",
            "telephone_number": "860-364-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "45 Reade Pl",
            "address_purpose": "LOCATION",
            "city": "Poughkeepsie",
            "state": "NY",
            "postal_code": "126013947",
            "country_code": "US",
            "telephone_number": "845-454-8500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SELBY",
        "first_name": "JENNIFER",
        "middle_name": "NICOLE",
        "credential": "RN, AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-20",
        "last_updated": "2025-08-28",
        "certification_date": "2025-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "14790",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NY",
            "license": "431159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, NY

Sources for this page

Verify at the official NPI Registry.