Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Brent William Fairchild, PA-C

Individual provider Physician Assistant · NPI 1174090393

Mr. Brent William Fairchild, PA-C is a Physician Assistant in Webster, New York. Qualified in 2020, 6 years ago. Practices with Internal Medicine Group, a 166-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
6
Licensed in
NY
In the registry since
2018
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1081 Bright Stream Way
Webster, NY 14580
Phone: (585) 410-0678
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 025179 (NY)
Physician Assistant Taxonomy 363A00000X · Licence 25179 (NY)

Record details

NPI number1174090393
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorYes
NPI enumeratedOctober 25, 2018
Last updated in NPPESJuly 3, 2023
Certification dateJuly 16, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Internal Medicine Group — 166 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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