Active NPI
Dana Mairead Free
- Pediatric Nurse Practitioner
- Valhalla, NY
National Provider Identifier
1578341970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- F383640-01
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
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
| License | State | Type | Specialty |
|---|---|---|---|
| 26NJ01381800 | NJ | MD | Pediatric Nurse Practitioner |
| F383640-01 | NY | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regents of the Univ of Ca | Current | Accepting new patients | |
| Regents of the Univ of Ca | Current | 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.
-
- Maternal & Fetal Medicine Physician
- Sacramento, CA
- NPI 1013906973
-
- Diagnostic Radiology Physician
- Sacramento, CA
- NPI 1477546406
-
- Trauma Surgery Physician
- Sacramento, CA
- NPI 1568455590
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; 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.