NPIMap

Individual provider Active NPI

Christian N Ezidiegwu, MD

  • Molecular Genetic Pathology (Pathology) Physician
  • Syracuse, NY
National Provider Identifier
1053364802
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Molecular Genetic Pathology (Pathology) PhysicianTaxonomy code 207ZP0007X
License
230913 Issued in NY
Practice address
100 Ostrom Ave
Syracuse, NY 13210-2029
Phone
(315) 447-7041
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Blood Banking & Transfusion Medicine Physician 207ZB0001X 230913 NY
Cytopathology Physician 207ZC0500X 230913 NY
Dermatopathology (Pathology) Physician 207ZD0900X 230913 NY
Forensic Pathology Physician 207ZF0201X 230913 NY
Immunopathology Physician 207ZI0100X 230913 NY
Medical Microbiology Physician 207ZM0300X 230913 NY
Molecular Genetic Pathology (Pathology) Physician 207ZP0007X 230913 NY Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 230913 NY
Pediatric Pathology Physician 207ZP0213X 230913 NY

Addresses

Primary practice location

100 Ostrom Ave
Syracuse, NY 13210-2029

Mailing address

100 Ostrom Ave
Syracuse, NY 13210-2029
Phone (315) 447-7041

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
I20040519000662 NY Practitioner - Pathology 5496746463 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Muzaffar N Khan Physician PCGroup PAC ID 4486729332, 3 clinicians
Associated Gastroenterologists of Central New York PCGroup PAC ID 3375512213, 14 clinicians

Practice addresses (Care Compare)

2209 Genesee St
Utica, NY 13501-5930
Phone (315) 798-8297

5100 W Taft Rd
Liverpool, NY 13088-3846
Phone (315) 452-2214

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.14 of 100Reported as group
Quality
81.4
Promoting interoperability
100
Improvement activities
40
Cost
79.06

Merit-based Incentive Payment System (MIPS)

Final score
96.01 of 100Reported as group
Quality
80.39
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
230913NYMDImmunopathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Gastroenterologists of Central New York, PC CurrentSince Jan 1, 2022 Accepting new patients
Muzaffar N Khan Physician PC Cytopathology CurrentSince Jan 20, 2020 Accepting new patients
Digestive Disease Medicine of Central New York, LLP CurrentSince Jan 1, 2025 Accepting new patients

Locations

260 Township Blvd
Ste 20
Camillus, NY 13031
Phone (315) 708-0091

4939 Brittonfield Pkwy
Ste 209
East Syracuse, NY 13057
Phone (315) 218-0085

7209 Buckley Rd
Liverpool, NY 13088
Phone (315) 299-5451

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

116 Business Park Dr
Ste 1
Utica, NY 13502
Phone (315) 624-7000

5700 Southwyck Blvd
Toledo, OH 43614

Interoperability endpoints

  • Direct secure messaging: cezidiegwu25422@mvhealthsystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 10

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": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1053364802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OSTROM AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102029",
            "telephone_number": "315-447-7041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 OSTROM AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102029",
            "telephone_number": "315-447-7041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EZIDIEGWU",
        "first_name": "CHRISTIAN",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZB0001X",
            "taxonomy_group": "",
            "desc": "Pathology, Blood Banking & Transfusion Medicine",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZF0201X",
            "taxonomy_group": "",
            "desc": "Pathology, Forensic Pathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZI0100X",
            "taxonomy_group": "",
            "desc": "Pathology, Immunopathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZM0300X",
            "taxonomy_group": "",
            "desc": "Pathology, Medical Microbiology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZP0007X",
            "taxonomy_group": "",
            "desc": "Pathology, Molecular Genetic Pathology",
            "state": "NY",
            "license": "230913",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "NY",
            "license": "230913",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.