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ASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, PC
NPI 1013938174
Internal Medicine - Gastroenterology in Camillus, NY

Active since July 22, 2006CLIA 33D2053918 · Certificate of Compliance
260 TOWNSHIP BLVD, STE 20, CAMILLUS, NY 13031(315) 708-0190(315) 488-3284 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2018, Nov 8, 2017 (2 updates tracked since 2017).

About Associated Gastroenterologists Of Central New York, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, PC (NPI 1013938174) is a healthcare organization registered as a gastroenterology in Camillus, New York and active in the NPI registry since July 2006. The organization holds a CLIA Certificate of Compliance certificate valid through March 26, 2027, maintains a secondary practice location in Syracuse, and lists Carol Gallup, Credentialing Coordinator, as its authorized official.

NPPES Registry Identity

NPI1013938174
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NameASSOCIATED GASTROENTEROLOGISTS OF CENTRAL NEW YORK, PC
Location Address260 TOWNSHIP BLVD, STE 20Camillus, NY 13031
Mailing Address260 Township Blvd, Ste 20Camillus, NY 13031 · (315) 708-0091 · Fax (315) 708-0194
Phone(315) 708-0190
Fax(315) 488-3284
Organization SubpartNo
Authorized OfficialCarol GallupCredentialing Coordinator · (315) 218-0085
Enumeration DateJuly 22, 2006
Last NPPES UpdateMarch 17, 20182 updates tracked since enumeration
✔ NPI 1013938174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
260 TOWNSHIP BLVD, Camillus, NY 13031
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Secondary Practice Location 1

Location 14870 Broad Rd, Suite 3QSyracuse, NY 13215-2206 · Phone (315) 492-5765 · Fax (315) 492-5123

Other Identifiers 3

Medicaid00482137NY
OtherCF1049NY · R/r Medicare
OtherCC7979NY · R/r Medicare

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 33D2053918

Associated Gastroenterologists Of Central New York PC Histopathology Lab · Liverpool, NY
Active · expires Mar 26, 2027
CLIA Number33D2053918
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateApril 18, 2018
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Christian N. Ezidiegwu
Laboratory Phone(315) 218-0085
Laboratory LocationAssociated Gastroenterologists Of Central New York PC Histopathology Lab5100 West Taft Rd Suite 3C, Liverpool, NY 13088
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

THEODORE KOH MD
Internal Medicine (Gastroenterology)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091
SCOTT A EDISON MD
Internal Medicine (Gastroenterology)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091
DR. JOHN SUN DO
Internal Medicine (Gastroenterology)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091
MRS. LISA HAWTHORNE A.N.P.
Nurse Practitioner (Adult Health)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091
JOHN A DALE MD
Internal Medicine (Gastroenterology)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0190
DR. MARGARET MARY BAILEY M.D.
Specialist
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0190
DR. THOMAS C LEE MD
Internal Medicine (Gastroenterology)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091
QUN XU NP
Nurse Practitioner (Family)
260 TOWNSHIP BLVD, STE 20
CAMILLUS, NY 13031
Onondaga County (315) 708-0091

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Associated Gastroenterologists Of Central New York, PC's NPI number?

The NPI number for Associated Gastroenterologists Of Central New York, PC is 1013938174. It was assigned to this organization in the NPPES registry on July 22, 2006.

Where is Associated Gastroenterologists Of Central New York, PC located?

Associated Gastroenterologists Of Central New York, PC is located at 260 Township Blvd Ste 20, Camillus, NY 13031. The listed phone number is (315) 708-0190.

What is Associated Gastroenterologists Of Central New York, PC's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Associated Gastroenterologists Of Central New York, PC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 33D2053918) is associated with this NPI, valid through March 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Associated Gastroenterologists Of Central New York, PC was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.