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

Andrew Kholodny

Individual provider Physician Assistant · NPI 1376305623

Andrew Kholodny is a Physician Assistant in Stony Brook, New York. Qualified in 2023, 3 years ago. Practices with Stony Brook Internists University Faculty Practice Corporation, a 428-clinician group and accepts Medicare assignment.

Years since qualifying
3
In the registry since
2024
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

101 Nicolls Road Health Sciences Center T-16 Rm 040
Stony Brook, NY 11794-8160
Phone: (631) 444-2066
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1376305623
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 23, 2024
Last updated in NPPESJanuary 26, 2024
Certification dateJanuary 26, 2024

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Stony Brook Internists University Faculty Practice Corporation — 428 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Stony Brook