Active NPI
Colleen Marie Fay, PA-C
- Physician Assistant
- Chandler, AZ
National Provider Identifier
1164071247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 8754
- Practice address
- 1955 W Frye Rd
Chandler, AZ 85224-6282 - Phone
- (480) 728-3000
- NPI assigned
- Sep 10, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | 8754 | AZ | Primary |
Addresses
Primary practice location
1955 W Frye Rd
Chandler, AZ 85224-6282
Mailing address
1955 W Frye Rd
Chandler, AZ 85224-6282
Phone (480) 789-0845
Other practice location 1
690 W Gary Ave
Gilbert, AZ 85233-2064
Phone (480) 789-0845
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8754 | AZ | MD | Physician Assistant |
Organizations & group practices 1
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.
-
- Emergency Medicine Physician
- Chandler, AZ
- NPI 1104871961
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642723200000",
"number": "1164071247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1955 W FRYE RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852246282",
"telephone_number": "480-789-0845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1955 W FRYE RD",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852246282",
"telephone_number": "480-728-3000"
}
],
"practiceLocations": [
{
"address_1": "690 W Gary Ave",
"address_purpose": "LOCATION",
"city": "Gilbert",
"state": "AZ",
"postal_code": "852332064",
"country_code": "US",
"telephone_number": "480-789-0845",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FAY",
"first_name": "COLLEEN",
"middle_name": "MARIE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-09-10",
"last_updated": "2022-01-21",
"certification_date": "2022-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "AZ",
"license": "8754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2022; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.