Organization Active NPI

Syracuse Endoscopy Associates, LLC

  • Endoscopy Clinic/Center
  • East Syracuse, NY
National Provider Identifier
1073587416
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endoscopy Clinic/CenterTaxonomy code 261QE0800X
License
3301219 Issued in NY
Legal business name
SYRACUSE ENDOSCOPY ASSOCIATES, LLC
Practice address
5000 Campuswood Drive
Suite 100
East Syracuse, NY 13057
Phone
(315) 234-6688
Fax
(315) 234-6689
NPI assigned
Feb 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Mrs. Kathleen M Kendrick, RN, MBA, MSN
Title
Administrator
Phone
(315) 234-6687

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endoscopy Clinic/Center 261QE0800X 3301219 NY Primary

Addresses

Primary practice location

5000 Campuswood Drive
Suite 100
East Syracuse, NY 13057

Mailing address

5000 Campuswood Drive
Suite 100
East Syracuse, NY 13057
Phone (315) 234-6688

Other identifiers 1

IdentifierTypeStateIssuer
02691514MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050816000778 NY Part B Supplier - Ambulatory Surgical Center 8921038373 Receives reassigned benefits from 1 practitioner
Practice locations: East Syracuse, NY

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Syracuse Endoscopy AssociatesCCN 33C0001085
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D1047534Syracuse Endoscopy Associates LLC5000 Campuswood Dr, East Syracuse, NY 13057Certificate of waiverMar 26, 2027

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1139875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1073587416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 CAMPUSWOOD DRIVE",
            "address_2": "SUITE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-234-6688",
            "fax_number": "315-234-6689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5000 CAMPUSWOOD DRIVE",
            "address_2": "SUITE 100",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "13057",
            "telephone_number": "315-234-6688",
            "fax_number": "315-234-6689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYRACUSE ENDOSCOPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-14",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "KENDRICK",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "315-234-6687",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN, MBA, MSN"
    },
    "taxonomies": [
        {
            "code": "261QE0800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Endoscopy",
            "state": "NY",
            "license": "3301219",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02691514",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.