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

Mrs. Irina Kholodny, R-PAC

Individual provider Physician Assistant · NPI 1255519617

Mrs. Irina Kholodny, R-PAC is a Physician Assistant in Massapequa, New York. Qualified in 1997, 29 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
29
Licensed in
NY
In the registry since
2008
Specialties on file
2
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Practice location Address checks out

585 Broadway
Massapequa, NY 11758
Phone: (516) 797-2146
Fax: (516) 797-0190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 0064151 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 006415 (NY)

Record details

NPI number1255519617
Entity typeIndividual (Type 1)
GenderFemale
Credentials R-PAC
Sole proprietorNo
NPI enumeratedFebruary 7, 2008
Last updated in NPPESJuly 11, 2008

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1997 (29 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

Other providers in Massapequa