Brandon Fairless, M.D.

Primary specialty

Pediatric Nephrology PhysicianTaxonomy code 2080P0210X

License

MD486184 Issued in PA

Practice address

3401 Civic Center Blvd
Philadelphia, PA 19104-4319

Phone

(215) 590-2449

NPI assigned

Mar 22, 2017

Last updated

Oct 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Surgery Physician
  • Danville, PA
  • NPI 1255382784

  Pediatrics

  NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Childrens Health Care Associates, Inc

  dba CHCA Neonatology

  • Neonatal-Perinatal Medicine Physician
  • Philadelphia, PA
  • NPI 1417042466
  NPD (past)
• Childrens Hospital of Philadelphia

  • Children's Hospital
  • Philadelphia, PA
  • NPI 1215921457
  NPD (past)
• Childrens Health Care Associates of New Jersey PC

  dba Chca NJ

  • Pediatrics Physician
  • Voorhees, NJ
  • NPI 1427152917
  NPD (past)

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1659802502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 CIVIC CENTER BLVD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044319",
            "telephone_number": "215-590-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRLESS",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-22",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "322248",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "PA",
            "license": "MD486184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fair Hill Community Physicians (Fair Hill Peds Physicians)
• Fair Hill Community Physicians
• Fair Hill Community Physicians (Fair Hill Pharmacy at Liberty Square)
• Constance S Fair, PA
• Grace Fairbrother
• Alexander Fairman
• Ronald M Fairman, MD
• Fairmount Pharmacy Inc
• Fairmount Pharmacy Services LLC
• Fairview Acquisitions LLC

• Pediatric Nephrology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Pediatric Nephrology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.