Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Braiden Clark Fairbanks, PA-C

Individual provider Physician Assistant · NPI 1164017679

Braiden Clark Fairbanks, PA-C is a Physician Assistant in Phoenix, Arizona. Qualified in 2021, 5 years ago. Practices with Mayo Clinic Arizona, a 1,616-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Arizona.

Years since qualifying
5
Licensed in
AZ
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

349 E Coronado Rd
Phoenix, AZ 85004-1525
Phone: (602) 266-5678
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 13400 E Shea Blvd, Scottsdale, AZ 85259-5499 — (480) 301-8000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8690 (AZ)

Record details

NPI number1164017679
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 5, 2021
Last updated in NPPESFebruary 24, 2025
Certification dateFebruary 24, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Mayo Clinic Arizona — 1616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Phoenix