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

Michael Nathen Warren, MPAS, PA-C

Individual provider Athletic Trainer · NPI 1114329810

Michael Nathen Warren, MPAS, PA-C is a Physician Assistant in Fayetteville, New York. Qualified in 2018, 8 years ago. Practices with Fife Dermatology Utah, a 3-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
8
Licensed in
UT
In the registry since
2014
Specialties on file
3
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 →

Practice location Address checks out

212 Highbridge St
Fayetteville, NY 13066-1981
Phone: (315) 637-9116
Fax: (315) 637-0436
Show map & directions

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 8177613-1206 (UT)
Athletic Trainer Taxonomy 2255A2300X · Licence 8177613-4810 (UT)
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1114329810
Entity typeIndividual (Type 1)
GenderMale
Credentials MPAS , PA-C
Sole proprietorNo
NPI enumeratedSeptember 24, 2014
Last updated in NPPESSeptember 8, 2021
Certification dateSeptember 8, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Fife Dermatology Utah — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fayetteville