FAIRFAX MEDICAL CLINIC PA
NPI 1447245279
Family Medicine in Fairfax, MN
About Fairfax Medical Clinic Pa NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
FAIRFAX MEDICAL CLINIC PA (NPI 1447245279) is a healthcare organization registered as a family medicine in Fairfax, Minnesota and active in the NPI registry since September 2005. The organization holds a CLIA Waiver certificate valid through January 21, 2027 and lists Thomas Frederick Gilles, Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 8
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Fairfax Medical Clinic Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Fairfax Medical Clinic PA, which bills Medicare for the services this clinician delivers.
Clinician (1)
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 24D0717350
Fairfax Medical Clinic · Fairfax, MNFrequently 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 Fairfax Medical Clinic PA's NPI number?
The NPI number for Fairfax Medical Clinic PA is 1447245279. It was assigned to this organization in the NPPES registry on September 19, 2005.
Where is Fairfax Medical Clinic PA located?
Fairfax Medical Clinic PA is located at 300 Park St S, Fairfax, MN 55332. The listed phone number is (507) 426-7228.
What is Fairfax Medical Clinic PA's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Fairfax Medical Clinic PA enrolled in Medicare?
Yes. Fairfax Medical Clinic PA is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Fairfax Medical Clinic PA?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Fairfax Medical Clinic PA. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Fairfax Medical Clinic PA hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 24D0717350) is associated with this NPI, valid through January 21, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Fairfax Medical Clinic PA accept?
Health plans from Medica list Fairfax Medical Clinic PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Fairfax Medical Clinic PA was last updated on April 20, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years 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.
# Fairfax Medical Clinic Pa · NPI 1447245279
Family Medicine organization in Fairfax, Minnesota. Organization record, active in the CMS NPPES registry since September 19, 2005.
## Identity
- **NPI:** 1447245279 (Entity type: Organization)
- **Enumerated:** September 19, 2005
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Thomas Gilles, PHYSICIAN
## Practice location
- **Address:** 300 PARK ST S, Fairfax, MN 55332-3153
- **Phone:** (507) 426-7228 · **Fax:** (507) 426-8257
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 20, 2008
- **Other identifiers:** Other =========100; Other 773742; Other 0105551; and 5 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1447245279) · Data from the CMS NPPES public registry.