Individual provider Active NPI

Brent G Nick, MD

  • Pediatrics Physician
  • Cedar Park, TX
National Provider Identifier
1023019205
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
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
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X Q8978 TX Primary
Pediatrics Physician 208000000X 40214 NH
Pediatric Adolescent Medicine Physician 2080A0000X 019461 LA

Addresses

Primary practice location

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

Mailing address

6210 E Highway 290
Austin, TX 78723-1142
Phone (512) 483-9596

Other practice location 1

11714 Wilson Parke Ave
Suite 150
Austin, TX 78726-4060
Phone (737) 247-7200

Other practice location 2

173 Middle St
Lancaster, NH 03584-3508
Phone (603) 788-4911

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250225002432 CA Practitioner - Pediatric Medicine 8527964659 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
40214NHMDPediatrics Physician
Q8978TXMDPediatrics Physician
019461LAMDPediatric Adolescent Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Santa Barbara County Auditor CurrentSince Feb 18, 2025 Accepting new patients
Santa Barbara County Auditor Current Accepting new patients
Santa Barbara County Auditor CurrentSince Feb 18, 2025 Accepting new patients
Westside Clinics Anc Pediatrics PastSince Dec 10, 2003 Accepting new patients

Locations

300 N San Antonio Rd
Santa Barbara, CA 93110
Phone (805) 681-5220

300 N San Antonio Rd
Rm 107
Santa Barbara, CA 93110
Phone (805) 681-5461

2115 Centerpointe Pkwy
Santa Maria, CA 93455
Phone (805) 346-7230

Interoperability endpoints

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "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"
        },
        {
            "address_1": "173 Middle St",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "NH",
            "postal_code": "035843508",
            "country_code": "US",
            "telephone_number": "603-788-4911",
            "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": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "Q8978",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "40214",
            "primary": false
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "LA",
            "license": "019461",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Park, TX

Sources for this page

Verify at the official NPI Registry.