Brent Lane Mazzagate

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1008894 Issued in TX

Practice address

1003 Nederland Ave
Nederland, TX 77627-2832

Phone

(409) 344-4466

NPI assigned

Nov 19, 2020

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mid County Medical Group PAGroup PAC ID 6305875923, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pam Rehabilitation Hospital of Beaumont Inpatient rehabilitation facility, Beaumont, TX, CCN 453048

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mid County Medical Group PA

  • Internal Medicine Physician
  • Port Arthur, TX
  • NPI 1568470136

  Family

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pam Squared at Beaumont, LLC

  dba PAM Rehabilitation Hospital of Beaumont

  • Rehabilitation Hospital
  • Beaumont, TX
  • NPI 1831550680

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1952904104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1003 NEDERLAND AVE",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776272832",
            "telephone_number": "409-344-4466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1003 NEDERLAND AVE",
            "city": "NEDERLAND",
            "state": "TX",
            "postal_code": "776272832",
            "telephone_number": "409-344-4466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZAGATE",
        "first_name": "BRENT",
        "middle_name": "LANE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-19",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1008894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Kareo",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "1003 Nederland Ave",
            "city": "Nederland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "776272832",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jodi Schion Love, N.P.-C.
• M.K. Hamza PH.D., P.a.
• Mark Beaty D.C.
• Christopher Earl Marrero, M.D.
• Michelle Marroquin, FNP
• Ronald Kent McCraw, PH.D.,D.O.,P.A.
• Ryan C McHugh, M.D.
• Melissa Christine McKey, RN, MSN, FNP-C
• William B McLendon, M.D.
• Michael Lloyd McMahon II, M.D.

• Family Nurse Practitioner in Nederland, TX
• Providers in Nederland, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.

Verify at the official NPI Registry.