1. Home
  2. Directory
  3. New York
  4. Manlius
  5. Family Medicine
  6. NPI Profile

FAIRGROUNDS FAMILY PHYSICIANS PLLC
NPI 1174690440
Family Medicine in Manlius, NY

Active since November 29, 2006CLIA 33D0682921 · Waiver
115 FAIRGROUNDS DRIVE, MANLIUS, NY 13104(315) 682-6165(615) 682-7929 Get Directions Write a Review

NPPES record last updated: January 9, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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

NPI1174690440
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFAIRGROUNDS FAMILY PHYSICIANS PLLC
Location Address115 FAIRGROUNDS DRIVEManlius, NY 13104
Mailing Address115 Fairgrounds DriveManlius, NY 13104 · (315) 682-6165 · Fax (615) 682-7929
Phone(315) 682-6165
Fax(615) 682-7929
Organization SubpartNo
Authorized OfficialPhilip KaplanMember · (315) 682-6165
Enumeration DateNovember 29, 2006
Last NPPES UpdateJanuary 9, 2025
NPPES CertifiedJanuary 9, 2025
✔ NPI 1174690440 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
115 FAIRGROUNDS DRIVE, Manlius, NY 13104
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

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, NY
Active · expires Aug 19, 2027
CLIA Number33D0682921
Laboratory TypeIndependent
Certificate Effective DateAugust 20, 2025
Certificate Expiration DateAugust 19, 2027
Laboratory DirectorDr. Philip Kaplan
Laboratory Phone(315) 682-6165
Laboratory LocationFairgrounds Family Physicians PLLC115 Fairgrounds Drive, Manlius, NY 13104
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. PHILIP KAPLAN MD
Family Medicine
115 FAIRGROUNDS DRIVE
MANLIUS, NY 13104
Onondaga County (315) 682-6165
DR. JARROD LAWRENCE BAGATELL MD
Family Medicine
115 FAIRGROUNDS DRIVE
MANLIUS, NY 13104
Onondaga County (315) 682-6165
MR. WAYNE W. RATH PT
Physical Therapist
115 FAIRGROUNDS DRIVE, SUITE 2
MANLIUS, NY 13104
Onondaga County (315) 682-3387
DR. KAREN OLIVER NARDELLA MD
Family Medicine
115 FAIRGROUNDS DRIVE
MANLIUS, NY 13104
Onondaga County (315) 682-6165

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 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.

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 18 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.