Individual provider Active NPI

Matthew Nickell, MD

  • Ophthalmology Physician
  • Burleson, TX
National Provider Identifier
1821593955
Registry record updated Mar 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
1821593955 Issued in TX
Practice address
2790 SW Wilshire Blvd
Burleson, TX 76028-8338
Phone
(817) 484-2020
NPI assigned
Mar 29, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X T4234 TX
Ophthalmology Physician 207W00000X 1821593955 TX Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

2790 SW Wilshire Blvd
Burleson, TX 76028-8338

Mailing address

2790 SW Wilshire Blvd
Burleson, TX 76028-8338
Phone (817) 484-2020

Other identifiers 1

IdentifierTypeStateIssuer
BP10064044OtherTXPHYSICIAN IN TRAINING LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20220413002208 TX Practitioner - Ophthalmology 8628325925 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Texas Medical School at Houston, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berry Eye Center PAGroup PAC ID 1254479538, 3 clinicians

Practice addresses (Care Compare)

2790 SW Wilshire Blvd
Burleson, TX 76028-8338
Phone (817) 484-2020

Merit-based Incentive Payment System (MIPS)

Final score
92.37 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.56

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery225

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1821593955TXMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Berry Eye Center PA Ophthalmology CurrentSince Jan 4, 2022 Accepting new patients

Locations

2790 SW Wilshire Blvd
Burleson, TX 76028
Phone (817) 484-2020

12001 South Fwy
Ste 101
Burleson, TX 76028
Phone (807) 615-4400

Interoperability endpoints

  • Direct secure messaging: mnickell@bsec.intellechartdirect.net
  • Direct secure messaging: matthew.nickell.1@12556.direct.athenahealth.com

Organizations & group practices 1

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": "1522281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774828800000",
    "number": "1821593955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2790 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288338",
            "telephone_number": "817-484-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2790 SW WILSHIRE BLVD",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760288338",
            "telephone_number": "817-484-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKELL",
        "first_name": "MATTHEW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-29",
        "last_updated": "2026-03-30",
        "certification_date": "2026-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "T4234",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "TX",
            "license": "1821593955",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN IN TRAINING LICENSE",
            "identifier": "BP10064044",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.