Brent G Nick, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

Q8978 Issued in TX

Practice address

801 E Whitestone Blvd Ste C
Cedar Park, TX 78613-7558

Phone

(512) 259-3467

NPI assigned

Aug 10, 2005

Sex

Male

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 3

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brent.nick.1@17363.direct.athenahealth.com

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.

• Santa Barbara County Auditor

  • General Acute Care Hospital
  • Santa Barbara, CA
  • NPI 1134162613
  Medicare reassignment NPD
• Santa Barbara County Auditor

  • Federally Qualified Health Center (FQHC)
  • Santa Maria, CA
  • NPI 1043302599
  NPD
• Santa Barbara County Auditor

  • Federally Qualified Health Center (FQHC)
  • Lompoc, CA
  • NPI 1649096249
  NPD
• Westside Clinics Anc

  • Pediatrics Physician
  • Marrero, LA
  • NPI 1265433320
  NPD (past)

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616371200000",
    "number": "1023019205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 E HIGHWAY 290",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787231142",
            "telephone_number": "512-483-9596",
            "fax_number": "512-406-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 E WHITESTONE BLVD STE C",
            "city": "CEDAR PARK",
            "state": "TX",
            "postal_code": "786137558",
            "telephone_number": "512-259-3467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11714 Wilson Parke Ave",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787264060",
            "country_code": "US",
            "telephone_number": "737-247-7200",
            "fax_number": "512-406-7368",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NICK",
        "first_name": "BRENT",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-10",
        "last_updated": "2021-03-22",
        "certification_date": "2021-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "LA",
            "license": "019461",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q8978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049405603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1901806",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "049405602",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Mai Nguyen, PHARMD
• Sophia Nguyen
• Trisha Nguyen
• Vian Lan-Phuong Nguyen, AA
• NHD PLLC
• Todd Peter Nieskes, LSA/CFA
• Amy Nikitenko, PSYD
• Nluc PLLC
• Kelsey Nollette, RN
• Katelyn Jeannette Norcia, CRNA

• Pediatrics Physician in Cedar Park, TX
• Providers in Cedar Park, TX by specialty
• Pediatrics Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.