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DR. BRANDON FAIRLESS M.D.
NPI 1659802502
Pediatrics - Pediatric Nephrology in Philadelphia, PA

Active since March 22, 2017PECOS Enrolled
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104(215) 590-2449 Get Directions Write a Review

NPPES record last updated: October 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 29, 2020, Mar 22, 2017 (2 updates tracked since 2017).

About Dr. Brandon Fairless M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. BRANDON FAIRLESS M.D. (NPI 1659802502) is an individual pediatric nephrology provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD486184) and active in the NPI registry since March 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2017).

NPPES Registry Identity

NPI1659802502
Entity TypeIndividualMale
Primary Taxonomy2080P0210X
Provider Legal NameDR. BRANDON FAIRLESSCredential: M.D.
Location Address3401 CIVIC CENTER BLVDPhiladelphia, PA 19104-4319
Mailing Address3401 Civic Center BlvdPhiladelphia, PA 19104-4319 · (215) 590-2449
Phone(215) 590-2449
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateMarch 22, 2017
Last NPPES UpdateOctober 15, 20252 updates tracked since enumeration
NPPES CertifiedOctober 15, 2025
✔ NPI 1659802502 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0210X
License✔ Licensed in PA · MD486184
Definition
A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.
Also ListedPediatricsTaxonomy 208000000X · License 322248 (LA)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
3401 CIVIC CENTER BLVD, Philadelphia, PA 19104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Brandon Fairless M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3678994050
PECOS Enrollment IDI20250724004434
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AARON DORFMAN M.D.
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - CARDIOLOGY
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-4040
MS. NICOLE MARIE KOEPKE CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD, CHILDREN'S HOSPITAL OF PHILADELPHIA - EMERGENCY MED
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1944
DR. CASSANDRA ALYS LIGH MD
Surgery (Plastic and Reconstructive Surgery)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-2208
DR. PREETI SOI
Psychiatry & Neurology (Child & Adolescent Psychiatry)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-7555
ROSALIND USHER M.D.
Pediatrics (Developmental - Behavioral Pediatrics)
3401 CIVIC CENTER BLVD, DIVISION OF DEVELOPMENTAL AND BEHAVIORAL PEDIATRICS
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-6336
DR. MATTHEW DAVID SCHREIER MD
Pediatrics (Pediatric Cardiology)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
DR. TERRENCE CALDWELL JR. PHARMD
Pharmacist (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000
ALYSSA STIEFEL CRNP
Nurse Practitioner (Pediatrics)
3401 CIVIC CENTER BLVD
PHILADELPHIA, PA 19104
Philadelphia County (215) 590-1000

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brandon Fairless's NPI number?

The NPI number for Brandon Fairless is 1659802502. It was assigned to this individual provider in the NPPES registry on March 22, 2017.

Where is Brandon Fairless located?

Brandon Fairless practices at 3401 Civic Center Blvd, Philadelphia, PA 19104. The listed phone number is (215) 590-2449.

What is Brandon Fairless's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Is Brandon Fairless enrolled in Medicare?

Yes. Brandon Fairless is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Brandon Fairless was last updated on October 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.