EDWIN FAIRFIELD – Physician Assistant, NPI 1407586035

EDWIN FAIRFIELD is a healthcare provider. based in Colorado springs, Colorado. specializing in PHYSICIAN ASSISTANT. They hold a License No. PA.0008177 (CO). The NPI Number for EDWIN FAIRFIELD is 1407586035

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
EDWIN FAIRFIELD
NPI
1407586035
Phone
(719) 622-6522
Address
1295 Kelly Johnson Blvd Ste 100
Enumeration Date
15 June 2022
Last Update Date
18 February 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7196226522
Graduation Year
2023 (3 years ago)
PAC ID
0648611756
Group Practice PAC ID
2163822511
Professional Enrollment ID
I20240507002357
Address ID
CO801329083MO1840XDRXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:3State licenses:1Digital endpointsOther names

4,161 PHYSICIAN ASSISTANT in CO

Provider Addresses for EDWIN FAIRFIELD

  • 1295 Kelly Johnson Blvd Ste 100

    Colorado Springs, CO 809203978

    Phone: (719) 622-6522

    Type: Location

  • 1840 Woodmoor Dr Ste 102

    Monument, CO 801329083

    Phone: (719) 622-6522

    Type: Location

  • 8580 Scarborough Dr Ste 125

    Colorado Springs, CO 809207584

    Phone: (719) 622-6522

    Type: Location

  • 131 W CENTER ST

    ALPINE, UT 840041341

    Phone:

    Type: Mailing

  • 1840 WOODMOOR DR STE 102

    MONUMENT, CO 801329083

    Phone:

    Type: Mailing

  • 1259 LAKE PLAZA DR STE 200

    COLORADO SPRINGS, CO 809063516

    Phone: (719) 622-6522

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-05-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240507002357IPhysician AssistantCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80920)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163822511View full group profile
NameSpecialtyState
P S Y C H I A T R YCO
Emergency MedicineOH
Mental Health CounselorCO
Physician AssistantCO
Mental Health CounselorCO
Nurse PractitionerCO
Mental Health CounselorCO
Physician AssistantCO
Marriage And Family TherapistCO

Reviews

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Frequently asked questions

What is the 10-digit NPI for EDWIN FAIRFIELD?
EDWIN FAIRFIELD — NPI 1407586035 — is the standard way to identify this listing.
Does the file indicate EDWIN FAIRFIELD is practicing under active NPI?
Directory data currently reports EDWIN FAIRFIELD as active.
What is EDWIN FAIRFIELD's primary classification?
Physician Assistant is the headline specialty for EDWIN FAIRFIELD here. Clinical services aligned with this taxonomy classification.
What address line appears for EDWIN FAIRFIELD?
EDWIN FAIRFIELD's geographic hint is Colorado Springs, Colorado in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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