VILLAGE OF FAYETTEVILLE
NPI 1033107586
Ambulance in Fayetteville, NY

Q: What is Village Of Fayetteville's NPI number?

The NPI number for Village Of Fayetteville is 1033107586. It was assigned to this organization in the NPPES registry on October 10, 2005.

Q: What is Village Of Fayetteville's specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Active since October 10, 2005CLIA 33D2316368 · Waiver

425 E GENESSE ST, FAYETTEVILLE, NY 13066(315) 637-9864(315) 637-0106 Get Directions Write a Review

NPPES record last updated: December 31, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Dec 31, 2025, Sep 17, 2020 (2 updates tracked since 2020).

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About Village Of Fayetteville NPPES

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

VILLAGE OF FAYETTEVILLE (NPI 1033107586) is a healthcare organization registered as an ambulance in Fayetteville, New York and active in the NPI registry since October 2005. The organization holds a CLIA Waiver certificate valid through March 26, 2027 and lists Karen Shepardson, Village Clerk - Treasurer, as its authorized official.

NPPES Registry Identity

NPI1033107586

Entity TypeOrganization

Primary Taxonomy341600000X

Legal Business NameVILLAGE OF FAYETTEVILLE

Location Address425 E GENESSE STFayetteville, NY 13066

Mailing AddressPo Box 535Baldwinsville, NY 13027-0535 · (315) 635-1789 · Fax (315) 635-3289

Phone(315) 637-9864

Fax(315) 637-0106

Organization SubpartNo

Authorized OfficialKaren ShepardsonVillage Clerk - Treasurer · (315) 637-9864

Enumeration DateOctober 10, 2005

Last NPPES UpdateDecember 31, 20252 updates tracked since enumeration

NPPES CertifiedDecember 31, 2025

✔ NPI 1033107586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAmbulanceTransportation Services

Taxonomy Code341600000X

Definition

An emergency vehicle used for transporting patients to a health care facility after injury or illness. Types of ambulances used in the United States include ground (surface) ambulance, rotor-wing (helicopter), and fixed-wing aircraft (airplane).

425 E GENESSE ST, Fayetteville, NY 13066

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Other Identifiers 2

OtherP00048271NY · Railroad Medicare

Medicaid02377402NY

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Village Of Fayetteville is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by March 31, 2027

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date

StateNew YorkEnrollment IDO20110325000833Non-DME Part B · Ambulance Service SupplierDue dateMarch 31, 2027

Source: CMS Revalidation Due Date List, October 2026 release.

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 33D2316368

Village Of Fayetteville · Fayetteville, NY

Active · expires Mar 26, 2027

CLIA Number33D2316368

Laboratory TypeAmbulance

Certificate Effective DateJanuary 3, 2025

Certificate Expiration DateMarch 26, 2027

Laboratory DirectorDr. Christian C. Knutsen

Laboratory Phone(315) 637-6101

Laboratory LocationVillage Of Fayetteville425 E Genesee St, Fayetteville, NY 13066

CLIA data matches this NPI record on: Name

This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 3

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.

Ground mileage, per statute mile A0425

Ground mileage per statute mile is a method of calculating the cost of transportation for medical services. It is used when a patient needs to be transported by ground ambulance. The cost is calculated per mile, from the pick-up location to the medical facility.

4,241 services341 patients

Ambulance service, basic life support, emergency transport (bls-emergency) A0429

Ambulance service with basic life support (BLS-Emergency) provides immediate transport for patients in critical situations. Medical professionals on board deliver essential care like CPR, wound dressing, and oxygen therapy to stabilize patients during the journey.

294 services205 patients

Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency) A0427

Ambulance Service, Advanced Life Support, Level 1 (ALS 1 - Emergency) is a critical care transport service for emergency situations. It includes a team of healthcare professionals equipped with advanced skills and tools to manage life-threatening conditions during transport.

235 services187 patients

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 Village Of Fayetteville's NPI number?

The NPI number for Village Of Fayetteville is 1033107586. It was assigned to this organization in the NPPES registry on October 10, 2005.

Where is Village Of Fayetteville located?

Village Of Fayetteville is located at 425 E Genesse St, Fayetteville, NY 13066. The listed phone number is (315) 637-9864.

What is Village Of Fayetteville's specialty?

The primary specialty registered for this NPI is Ambulance with taxonomy code 341600000X.

Is Village Of Fayetteville enrolled in Medicare?

Yes. Village Of Fayetteville is registered in the Medicare PECOS enrollment system.

When is Village Of Fayetteville's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (New York, Ambulance Service Supplier) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Village Of Fayetteville hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 33D2316368) 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 Village Of Fayetteville was last updated on December 31, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.