UPSTATE GASTROENTEROLOGY, LLC (NPI# 1366799033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366799033 |
| Entity Type | Organization |
| Organization Name | UPSTATE GASTROENTEROLOGY, LLC |
| Practice Address |
1000 E Genesee St Suite 206 Syracuse NY 13210-1892 |
| Practice Telephone | 3154641616 |
| Practice Fax Number | 3154641617 |
| Mailing Telephone | 3154641616 |
| Mailing Fax Number | 3154641617 |
| Enumeration Date | 2012-08-13 |
| Last Update Date | 2015-03-02 |
| Authorized Official Name | MICHAEL C. IANNUZZI (MD) |
| Authorized Official Telephone | 3154643835 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
111362 | NY | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03747028 | 05 |
| Street Address |
1000 E GENESEE ST SUITE 206 |
| City | SYRACUSE |
| State | NY |
| Zip Code | 13210-1892 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689672230 | Robert D Kirk | Physician Assistant | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1892 | 2005-07-08 |
| 1396284733 | Sarah Benton | Nurse Practitioner | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1892 | 2017-02-17 |
| 1366877540 | Lana Catherine Gagne | Nurse Practitioner | 1000 E Genesee St, Ste 500, Syracuse, NY 13210-1885 | 2013-09-06 |
| 1821347683 | Jarmel Physical Therapy, Pllc | Clinic/Center | 1000 E Genesee St, Hill Medical Center Suite# 202, Syracuse, NY 13210-1892 | 2012-09-06 |
| 1528314879 | Southern New York Neurosurgical Group, P.C. | Neurological Surgery | 1000 E Genesee St, Suite 602, Syracuse, NY 13210-1892 | 2012-07-24 |
| 1467713149 | David J Davin Md Pllc | Internal Medicine | 1000 E Genesee St, Suite 204, Syracuse, NY 13210-1892 | 2012-05-30 |
| 1386942092 | Associated Healthcare Systems Inc | Durable Medical Equipment & Medical Supplies | 1000 E Genesee St, Ste 300, Syracuse, NY 13210-1853 | 2011-03-03 |
| 1982902730 | Associated Healthcare Systems Inc | Durable Medical Equipment & Medical Supplies | 1000 E Genesee St, Ste 402, Syracuse, NY 13210-1853 | 2011-03-03 |
| 1629374210 | Jamie Lynn Nelson | Physician Assistant | 1000 E Genesee St, Suite 300, Syracuse, NY 13210-1892 | 2011-01-31 |
| 1770885469 | Susan Jarmel | Physical Therapist | 1000 E Genesee St, Hill Medical Center Suite 202, Syracuse, NY 13210-1892 | 2010-12-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558973586 | Maizie Marie Shaw | Social Worker | 660 Madison Street, Syracuse, NY 13210 | 2020-08-20 |
| 1427666916 | Christine Marie Welker | Registered Nurse | 735 Irving Avenue, Syracuse, NY 13210 | 2020-07-21 |
| 1386263994 | Ashwini Krishna Ashwath | Student in an Organized Health Care Education/Training Program | 750 E. Adams Street, Syracuse, Ny 13210, Syracuse, NY 13210 | 2020-04-14 |
| 1073142329 | Kamala Ojha | Student in an Organized Health Care Education/Training Program | 750-east Adam's Street, Syracuse, NY 13210 | 2020-04-07 |
| 1003442369 | Brittany Nicole Lippert | Counselor | 615 Madison St, Syracuse, NY 13210 | 2020-03-19 |
| 1902430499 | Dkt Physician Pllc | Internal Medicine | 475 Irving Ave, Suite 410, Syracuse, NY 13210 | 2020-02-24 |
| 1376194720 | Sarah Van Eenenaam | Physician Assistant | Adult Cardiac Surgery, 750 East Adams St, Syracuse, NY 13210 | 2019-09-26 |
| 1265099022 | Michelle Gallagher | Psychologist | Upstate Medical University, 750 E. Adams St., Syracuse, NY 13210 | 2019-05-28 |
| 1639659428 | Francesca Wanda Cotrupe | Physical Medicine & Rehabilitation | Upstate Medical University Hospital, 750 E Adams Street, Syracuse, NY 13210 | 2018-08-21 |
| 1700370327 | Dallin Lindahl | Physical Medicine & Rehabilitation | 750 E Adams St # Jh308, Syracuse, NY 13210 | 2018-06-18 |
| Find all providers in zip 13210 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639261365 | Specialists One- Day Surgery LLC | Clinic/Center | 190 Intrepid Ln, Syracuse, NY 13205-2545 | 2006-09-29 |
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| 1083220123 | Queens Surgical Center LLC | Clinic/Center | 3636 Main St Ste 1s, Flushing, NY 11354-6517 | 2020-09-22 |
| 1083230833 | Surgicare of Westside, LLC | Clinic/Center | 438 W 51st St Fl 5, New York, NY 10019-6503 | 2020-06-17 |
| 1780206292 | Greece Asc, LLC | Clinic/Center | 135 Canal Landing Blvd, Rochester, NY 14626-5104 | 2020-05-07 |
| 1679108914 | Precision Sc, LLC | Clinic/Center | 28 Research Way, East Setauket, NY 11733-3453 | 2020-03-06 |
| 1043845340 | Northeast Endoscopy LLC | Clinic/Center | 235 N Belle Mead Ave, East Setauket, NY 11733-3456 | 2020-03-06 |
| 1295365864 | North Fork Surgery Center LLC | Clinic/Center | 700 Boisseau Ave, Southold, NY 11971 | 2020-01-22 |
| 1083262539 | Uptown Surgical Services P.c | Clinic/Center | 111 East 71st Street, New York, NY 10021 | 2019-08-28 |
| 1154973071 | Albany Med Niskayuna Ambulatory Endoscopy and Surgery Center | Clinic/Center | 1769 Union Street, 3rd Floor, Niskayana, NY 12309 | 2019-07-11 |
| 1922666940 | Gpddc, LLC | Clinic/Center | 2 Bennett Ave Fl 2, New York, NY 10033-2148 | 2019-06-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.