NPIMap

Individual provider Active NPI

Matthew K. Fairbank, RPA-C

  • Medical Physician Assistant
  • Cooperstown, NY
National Provider Identifier
1184622516
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
007814 Issued in NY
Practice address
1 Atwell Rd
Cooperstown, NY 13326
Phone
(607) 547-3180
NPI assigned
Jul 11, 2005
Last updated
Oct 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 007814 NY Primary

Addresses

Primary practice location

1 Atwell Rd
Cooperstown, NY 13326

Mailing address

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

Other identifiers 1

IdentifierTypeStateIssuer
02321204MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040901000899 NY Practitioner - Physician Assistant 2567437536 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Imogene Bassett HospitalGroup PAC ID 3779488325, 780 clinicians
Saratoga HospitalGroup PAC ID 6406740273, 353 clinicians

Practice addresses (Care Compare)

1 Atwell Rd
Cooperstown, NY 13326-1394

1 Norton Ave
Oneonta, NY 13820-2629
Phone (607) 547-3456

178 Grandview Dr
Cobleskill, NY 12043-5144
Phone (518) 254-3456

211 Church St
Saratoga Springs, NY 12866-1003

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Saratoga Hospital CurrentSince Jun 16, 2020 Accepting new patients
Mary Imogene Bassett Hospital CurrentSince Apr 14, 2025 Accepting new patients
Saratoga Hospital CurrentSince Jun 16, 2020 Accepting new patients
Saratoga Hospital CurrentSince Dec 22, 2020 Accepting new patients
St. Peter's Health Partners Medical Associates, P.C. CurrentSince Jan 1, 2013 Accepting new patients
Saratoga Hospital Past Accepting new patients

Locations

2 Palisades Dr
Albany, NY 12205

2 Palisades Dr
Ste 200
Albany, NY 12205

178 Grandview Dr
Cobleskill, NY 12043
Phone (518) 254-3456

1 Atwell Rd
Cooperstown, NY 13326
Phone (607) 547-3480

1 West Ave
Ste 300
Saratoga Springs, NY 12866
Phone (518) 693-4699

211 Church St
Saratoga Springs, NY 12866
Phone (518) 583-8461

2 New Hampshire Ave
Troy, NY 12180
Phone (518) 272-0331

130 North St
Walton, NY 13856
Phone (607) 865-6541

Interoperability endpoints

  • Direct secure messaging: mfairbank566287@bassett.direct-ci.net
  • Direct secure messaging: mfairbank98299@albanymed.direct-ci.com

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1184622516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ATWELL RD",
            "city": "COOPERSTOWN",
            "state": "NY",
            "postal_code": "13326",
            "telephone_number": "607-547-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRBANK",
        "first_name": "MATTHEW",
        "middle_name": "K.",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "007814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02321204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cooperstown, NY

Sources for this page

Verify at the official NPI Registry.