Benny Fair Jr., D.P.M.

Primary specialty

PodiatristTaxonomy code 213E00000X

License

07000728 Issued in IN

Practice address

2700 Lafayette St
Suite 120
Fort Wayne, IN 46806-1100

Phone

(260) 458-9953

Fax

(260) 458-9238

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Dr. Benny Fair Jr. Professional name

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Podiatry

Education

William M. Scholl College of Podiatric Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bfair4170@direct.parkviewexchange.com

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.

• Lafayette Foot and Ankle Clinic LLC

  • Podiatrist
  • Fort Wayne, IN
  • NPI 1003193814
  Medicare reassignment Authorized official
• Alliance Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1316556848
  Medicare reassignment NPD
• Alliance Health Centers Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, IN
  • NPI 1013880913
  NPD

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1295838365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST",
            "address_2": "STE 100",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-458-9953",
            "fax_number": "260-458-9238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 LAFAYETTE ST",
            "address_2": "SUITE 120",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468061100",
            "telephone_number": "260-458-9953",
            "fax_number": "260-458-9238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIR",
        "first_name": "BENNY",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "IN",
            "license": "07000728",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "000000331259",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100082090A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00128864",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BENNY",
            "last_name": "FAIR",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "D.P.M.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Patricia Oghogho Ezeakudo
• Fab Mental Health Counseling LLC
• Jessica Fabian
• Jean M Fabini, NP
• Ellen Catherine Fagan-Pryor, MSN, PMHCNS, RN
• Alyssa B Fairbanks, PTA
• Joshua Fairbanks
• Shah Faisal
• John M Falatko
• Stephanie R Falatko, D.O.

• Podiatrist in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Podiatrist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 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.