Individual provider Active NPI

Gustavo De la Roza, MD

  • Cytopathology Physician
  • Syracuse, NY
National Provider Identifier
1336253186
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cytopathology PhysicianTaxonomy code 207ZC0500X
License
216982-1 Issued in NY
Practice address
750 E Adams St
Syracuse, NY 13210-2306
Phone
(315) 464-6751
Fax
(315) 464-6749
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cytopathology Physician 207ZC0500X 216982-1 NY Primary
Anatomic Pathology Physician 207ZP0101X 216982-1 NY

Addresses

Primary practice location

750 E Adams St
Syracuse, NY 13210-2306

Mailing address

250 Harrison St
Suite 502
Syracuse, NY 13202-3065
Phone (315) 464-6751

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040519000575 NY Practitioner - Pathology 0244221315 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Pathologists Laboratories, LLPGroup PAC ID 8325038276, 25 clinicians

Practice addresses (Care Compare)

750 E Adams St
Syracuse, NY 13210-2306
Phone (315) 464-4750

Hospital & facility affiliations

  • University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241
  • Carthage Area Hospital, Inc Hospital, Ogdensburg, NY, CCN 331324

Merit-based Incentive Payment System (MIPS)

Final score
76.3 of 100Reported as group
Quality
70
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
216982-1NYMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Medical Service Group Inc Current Accepting new patients
Methodist Pathology Associates PLLC Cytopathology PastSince Aug 3, 2025 Accepting new patients

Locations

750 E Adams St
Syracuse, NY 13210
Phone (315) 464-4363

Interoperability endpoints

  • Direct secure messaging: gdelaroza7416@direct.upstate.edu

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 2

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": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1336253186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 HARRISON ST",
            "address_2": "SUITE 502",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132023065",
            "telephone_number": "315-464-6751",
            "fax_number": "315-464-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 E ADAMS ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102306",
            "telephone_number": "315-464-6751",
            "fax_number": "315-464-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA ROZA",
        "first_name": "GUSTAVO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZC0500X",
            "taxonomy_group": "",
            "desc": "Pathology, Cytopathology",
            "state": "NY",
            "license": "216982-1",
            "primary": true
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "NY",
            "license": "216982-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

Verify at the official NPI Registry.