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UPSTATE GASTROENTEROLOGY, LLC
NPI 1366799033
Clinic/Center - Ambulatory Surgical in Syracuse, NY

Active since August 13, 2012CLIA 33D1051896 · Waiver
1000 E GENESEE ST, SUITE 206, SYRACUSE, NY 13210(315) 464-1616(315) 464-1617 Get Directions Write a Review

NPPES record last updated: March 2, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Upstate Gastroenterology, Llc NPPES

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

UPSTATE GASTROENTEROLOGY, LLC (NPI 1366799033) is a healthcare organization registered as an ambulatory surgical in Syracuse, New York and active in the NPI registry since August 2012. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Michael C. Iannuzzi, Md, as its authorized official.

NPPES Registry Identity

NPI1366799033
Entity TypeOrganization
Primary Taxonomy261QA1903X
Legal Business NameUPSTATE GASTROENTEROLOGY, LLC
Location Address1000 E GENESEE ST, SUITE 206Syracuse, NY 13210-1892
Mailing Address1000 E Genesee St, Suite 206Syracuse, NY 13210-1892 · (315) 464-1616 · Fax (315) 464-1617
Phone(315) 464-1616
Fax(315) 464-1617
Organization SubpartNo
Authorized OfficialMichael C. IannuzziMd · (315) 464-3835
Enumeration DateAugust 13, 2012
Last NPPES UpdateMarch 2, 2015
✔ NPI 1366799033 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Ambulatory SurgicalAmbulatory Health Care Facilities
Taxonomy Code261QA1903X
License✔ Licensed in NY · 111362
1000 E GENESEE ST, Syracuse, NY 13210
Open in Google Maps ↗

Other Identifiers 2

Medicaid03747028NY
Medicare PINJ300089429NY

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 Waiver 33D1051896

Upstate Gastroenterology LLC · Syracuse, NY
Active · expires Mar 26, 2027
CLIA Number33D1051896
Laboratory TypeAmbulatory Surgery Center
Certificate Effective DateDecember 18, 2012
Certificate Expiration DateMarch 26, 2027
Laboratory DirectorDr. Savio D. John
Laboratory Phone(315) 464-1616
Laboratory LocationUpstate Gastroenterology LLC1000 E Genesee St - Suite 206, Syracuse, NY 13210
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
14 services13 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
12 services12 patients

Other Providers at the Same Location NPPES 20

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

AMY ELIZABETH ROY NP
Family Medicine (Adult Medicine)
1000 E GENESEE ST, SUITE 300
SYRACUSE, NY 13210
Onondaga County (315) 471-1044
ANTHONY F CERMINARO NP
Nurse Practitioner
1000 E GENESEE ST, SUITE 403
SYRACUSE, NY 13210
Onondaga County (315) 464-8200
MICHAEL P GABRIS MD FACC
Internal Medicine (Cardiovascular Disease)
1000 E GENESEE ST, SUITE 300
SYRACUSE, NY 13210
Onondaga County (315) 471-1044
VOJTECH SLEZKA MD
Internal Medicine (Cardiovascular Disease)
1000 E GENESEE ST, STE 300
SYRACUSE, NY 13210
Onondaga County (315) 471-1044
MRS. JESSICA KATHRYN LOCKWOOD RPA-C
Physician Assistant
1000 E GENESEE ST, SUITE 500
SYRACUSE, NY 13210
Onondaga County (315) 471-8388
EUGENE C LOZNER MD FACC
Internal Medicine (Cardiovascular Disease)
1000 E GENESEE ST, SUITE 300
SYRACUSE, NY 13210
Onondaga County (315) 471-1044
FARAH DERMATOLOGY AND COSMETICS LLC
Dermatology
1000 E GENESEE ST, SUITE 601
SYRACUSE, NY 13210
Onondaga County (315) 422-8331
LYNN A O'DONNELL NP
Nurse Practitioner (Adult Health)
1000 E GENESEE ST, SUITE 300
SYRACUSE, NY 13210
Onondaga County (315) 471-1044

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 Upstate Gastroenterology, LLC's NPI number?

The NPI number for Upstate Gastroenterology, LLC is 1366799033. It was assigned to this organization in the NPPES registry on August 13, 2012.

Where is Upstate Gastroenterology, LLC located?

Upstate Gastroenterology, LLC is located at 1000 E Genesee St Suite 206, Syracuse, NY 13210. The listed phone number is (315) 464-1616.

What is Upstate Gastroenterology, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Ambulatory Surgical, with taxonomy code 261QA1903X.

Does Upstate Gastroenterology, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D1051896) 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 Upstate Gastroenterology, LLC was last updated on March 2, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.