Braiden Clark Fairbanks, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

8690 Issued in AZ

Practice address

349 E Coronado Rd
Phoenix, AZ 85004-1525

Phone

(602) 266-5678

NPI assigned

Mar 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103
• Yavapai Regional Medical Center Hospital, Prescott, AZ, CCN 030012

Merit-based Incentive Payment System (MIPS)

Final score

81.75 of 100Reported as group

Quality

60.45

Promoting interoperability

97

Improvement activities

40

Cost

81.21

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.

• Mayo Clinic Arizona

  • Multi-Specialty Clinic/Center
  • Scottsdale, AZ
  • NPI 1558332494
  Medicare reassignment Care Compare group NPD
• Arizona Digestive Health, PC

  • Gastroenterology Physician
  • Scottsdale, AZ
  • NPI 1992981583
  Medicare reassignment
• Mayo Clinic Arizona

  • Durable Medical Equipment & Medical Supplies
  • Phoenix, AZ
  • NPI 1699520049
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Arizona

  • General Acute Care Hospital
  • Phoenix, AZ
  • NPI 1154392231
  Care Compare affiliation
• Yavapai Community Hospital Association

  • General Acute Care Hospital
  • Prescott, AZ
  • NPI 1902897820
  Care Compare affiliation

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

{
    "created_epoch": "1614902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1164017679",
    "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": "480-721-1784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "349 E CORONADO RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041525",
            "telephone_number": "602-266-5678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13400 E Shea Blvd",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852595499",
            "country_code": "US",
            "telephone_number": "480-301-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAIRBANKS",
        "first_name": "BRAIDEN",
        "middle_name": "CLARK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-05",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "8690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bfairbanks2421371@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Faiith Group Home LLC
• Karen Marie Fain, MFT
• Matthew D Fain, DO
• Annie Fair, M.S.W.
• Mary Fairbairn-Rodriguez
• Ronald T Faircloth, LPC, LISAC
• Fairclough Behavior Services LLC Az
• Rebecca Joanne Fairfax, OTR L
• Fairmont Pharmacy, LLC
• Faith & Courage Psychiatry and Beyond LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.