Danae Frederico, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

58585 Issued in CA

Practice address

2001 Santa Monica Blvd Ste 680W
Santa Monica, CA 90404-2111

Phone

(310) 829-8928

NPI assigned

Oct 20, 2016

Last updated

Dec 17, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Danae Davis Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Saint Johns Medical FoundationGroup PAC ID 0840548624, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint John's Health Center Hospital, Santa Monica, CA, CCN 050290

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Saint Johns Medical Foundation

  dba Saint John's Physician Partners

  • Specialist
  • Santa Monica, CA
  • NPI 1770093734
  Medicare reassignment Care Compare group NPD
• Healthy Smiles for Kids of Orange County

  • Pediatric Dentistry
  • Garden Grove, CA
  • NPI 1720292949
  NPD (past)
• Saint John's Health Clinic

  dba Providence Saint John's Health Clinic

  • Specialist
  • Santa Monica, CA
  • NPI 1336438902
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Providence Saint John's Health Center

  • General Acute Care Hospital
  • Santa Monica, CA
  • NPI 1124026273
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1476921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1417408865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 680W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042111",
            "telephone_number": "310-829-8928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 SANTA MONICA BLVD STE 680W",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042111",
            "telephone_number": "310-829-8928"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15211 Vanowen St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Van Nuys",
            "state": "CA",
            "postal_code": "914053606",
            "country_code": "US",
            "telephone_number": "818-782-4232",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FREDERICO",
        "first_name": "DANAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-20",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "58585",
            "primary": true
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "26279",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL HYGIENE COMMITTEE OF CALIFORNIA",
            "identifier": "26279",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANAE",
            "last_name": "DAVIS",
            "credential": "RDH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kittie Frantz, RN, CPNP-PC
• Harriet Mary Fraser
• Mary Jo Frazier-Wilzig, DDS
• Frederick J Karubian, M D a Professional Medical Corporation
• Hal M Frederick, MD
• Benjamin Freed
• Marcia Freedland, CCC-SLP
• Douglas M Freedman, MD
• Carole Beverly Freeman, MFTI
• Yvonne Michelle Freiberger, LVN

• Physician Assistant in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.