Individual provider Active NPI

Dana Mairead Free

  • Pediatric Nurse Practitioner
  • Valhalla, NY
National Provider Identifier
1578341970
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F383640-01 Issued in NY
Practice address
95 Bradhurst Ave
Valhalla, NY 10595-1697
Phone
(914) 592-7555
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 26NJ01381800 NJ
Pediatric Nurse Practitioner 363LP0200X F383640-01 NY Primary

Addresses

Primary practice location

95 Bradhurst Ave
Valhalla, NY 10595-1697

Mailing address

23 Farmgate Dr
Colts Neck, NJ 07722-1708
Phone (732) 850-3062

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20260116000296 CA Practitioner - Nurse Practitioner 4284111618 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10545 Armstrong Ave
Suite 1200
Mather, CA 95655-4101

10850 White Rock Rd
Rancho Cordova, CA 95670-6044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NJ01381800NJMDPediatric Nurse Practitioner
F383640-01NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca CurrentSince Dec 17, 2025 Accepting new patients
Regents of the Univ of Ca CurrentSince Dec 17, 2025 Accepting new patients

Locations

2521 Stockton Blvd
Ste 3200
Sacramento, CA 95817
Phone (916) 734-3112

2221 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-2680

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1578341970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FARMGATE DR",
            "city": "COLTS NECK",
            "state": "NJ",
            "postal_code": "077221708",
            "telephone_number": "732-850-3062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 BRADHURST AVE",
            "city": "VALHALLA",
            "state": "NY",
            "postal_code": "105951697",
            "telephone_number": "914-592-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREE",
        "first_name": "DANA",
        "middle_name": "MAIREAD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "26NJ01381800",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F383640-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valhalla, NY

Sources for this page

Verify at the official NPI Registry.