NPIMap

Individual provider Active NPI

Randolph A. Hennigar, PH.D., M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Stony Brook, NY
National Provider Identifier
1467410266
Registry record updated Oct 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
36776 Issued in GA
Practice address
Department of Pathology 101 Nicolls Rd BST-9T RM 140
Stony Brook, NY 11794-1059
Phone
(770) 843-1990
NPI assigned
May 2, 2006
Last updated
Oct 12, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 307626 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 36776 GA Primary

Addresses

Primary practice location

Department of Pathology 101 Nicolls Rd BST-9T RM 140
Stony Brook, NY 11794-1059

Mailing address

Department of Pathology 101 Nicolls Rd BST-9T RM 140
Stony Brook, NY 11794-8691
Phone (770) 843-1990

Other practice location 1

1364 Clifton Rd NE
Room H194
Atlanta, GA 30322-1059
Phone (404) 727-9885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201224000603 NY Practitioner - Pathology 4981735313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Medical University of South Carolina College of Medicine, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Nicolls Rd
Stony Brook, NY 11790-3407
Phone (631) 444-2222

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Stony Brook Pathologists, University Faculty Practice Corporation CurrentSince Oct 15, 2020 Accepting new patients
University Hospital at Stony Brook Current Accepting new patients
Nephropathology Associates, PLC Anatomic Pathology Past Accepting new patients

Locations

100 Nicolls Rd
Stony Brook, NY 11790
Phone (631) 444-1069

101 Nicolls Rd
Rm 140
Stony Brook, NY 11794
Phone (631) 444-3000

Interoperability endpoints

  • Direct secure messaging: randolph.hennigar@direct.stonybrookmedicine.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791763200000",
    "number": "1467410266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PATHOLOGY 101 NICOLLS RD BST-9T RM 140",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117948691",
            "telephone_number": "770-843-1990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEPARTMENT OF PATHOLOGY 101 NICOLLS RD BST-9T RM 140",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117941059",
            "telephone_number": "770-843-1990"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1364 Clifton Rd NE",
            "address_2": "Room H194",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221059",
            "country_code": "US",
            "telephone_number": "404-727-9885",
            "fax_number": "404-727-3133",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENNIGAR",
        "first_name": "RANDOLPH",
        "middle_name": "A.",
        "credential": "PH.D., M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2026-10-12",
        "certification_date": "2026-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "307626",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "36776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stony Brook, NY

Sources for this page

Verify at the official NPI Registry.