FAIRGROUNDS FAMILY PHYSICIANS PLLC
NPI 1174690440
Family Medicine in Manlius, NY
About Fairgrounds Family Physicians Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAIRGROUNDS FAMILY PHYSICIANS PLLC (NPI 1174690440) is a healthcare organization registered as a family medicine in Manlius, New York and active in the NPI registry since November 2006. The organization holds a CLIA Waiver certificate valid through August 19, 2027 and lists Philip Kaplan, Member, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fairgrounds Family Physicians Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Fairgrounds Family Physicians PLLC, which bills Medicare for the services they deliver. Of these, 2 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 33D0682921
Fairgrounds Family Physicians PLLC · Manlius, NYFrequently 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 Fairgrounds Family Physicians PLLC's NPI number?
The NPI number for Fairgrounds Family Physicians PLLC is 1174690440. It was assigned to this organization in the NPPES registry on November 29, 2006.
Where is Fairgrounds Family Physicians PLLC located?
Fairgrounds Family Physicians PLLC is located at 115 Fairgrounds Drive, Manlius, NY 13104. The listed phone number is (315) 682-6165.
What is Fairgrounds Family Physicians PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Fairgrounds Family Physicians PLLC enrolled in Medicare?
Yes. Fairgrounds Family Physicians PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fairgrounds Family Physicians PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Fairgrounds Family Physicians PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 2 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Fairgrounds Family Physicians PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 33D0682921) is associated with this NPI, valid through August 19, 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 Fairgrounds Family Physicians PLLC was last updated on January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Fairgrounds Family Physicians Pllc · NPI 1174690440
Family Medicine organization in Manlius, New York. Organization record, active in the CMS NPPES registry since November 29, 2006.
## Identity
- **NPI:** 1174690440 (Entity type: Organization)
- **Enumerated:** November 29, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Philip Kaplan, MEMBER
## Practice location
- **Address:** 115 FAIRGROUNDS DRIVE, Manlius, NY 13104
- **Phone:** (315) 682-6165 · **Fax:** (615) 682-7929
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R); 2 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 9, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174690440) · Data from the CMS NPPES public registry.