Danielle Fairbanks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8028 Issued in AZ

Practice address

1744 S Val Vista Dr Ste 5-108
Mesa, AZ 85204-7362

Phone

(888) 663-6631

Fax

(415) 252-7176

NPI assigned

Jul 6, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Omg Arizona LLCGroup PAC ID 9638499247, 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Omg Arizona, LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1184014854
  Medicare reassignment Care Compare group
• Greenfield Family Medicine LLC

  • Medical Physician Assistant
  • Mesa, AZ
  • NPI 1336255264
  Medicare reassignment
• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1619376456
  Medicare reassignment
• Maniilaq Association

  • Rural Acute Care Hospital
  • Kotzebue, AK
  • NPI 1861698805

  TX

  Medicare reassignment
• Iora Senior Health, LLC

  • Internal Medicine Physician
  • Arvada, CO
  • NPI 1760867428
  NPD
• Maniilaq Association

  • Critical Access Hospital
  • Kotzebue, AK
  • NPI 1316995210
  NPD
• Maniilaq Association

  • Federal Public Health Clinic/Center
  • Noorvik, AK
  • NPI 1720355456
  NPD
• One Medical Group of Arizona, PC

  • Family Medicine Physician
  • San Francisco, CA
  • NPI 1962807297
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1593993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742169600000",
    "number": "1083232177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "253 N PIEDRA",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852077561",
            "telephone_number": "262-366-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1744 S VAL VISTA DR STE 5-108",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047362",
            "telephone_number": "888-663-6631",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "DANIELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-06",
        "last_updated": "2025-03-17",
        "certification_date": "2025-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Eve Fahs, PA-S
• Faiella Family Investments LLC
• Andrew Faiella
• Megan Fain, DPT
• Luisa P Fainu
• Cory Fairchild, LMT
• Faith Care Homes
• Faithful Guardians Home Care
• Saeed Fakhran, MD
• Michelle Falcon

• Physician Assistant in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.