BRENT LANE MAZZAGATE – Family Nurse Practitioner, NPI 1952904104

BRENT LANE MAZZAGATE is a healthcare provider. based in Nederland, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 1008894 (TX). The NPI Number for BRENT LANE MAZZAGATE is 1952904104

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
BRENT LANE MAZZAGATE
NPI
1952904104
Phone
(409) 344-4466
Address
1003 NEDERLAND AVE
Enumeration Date
19 November 2020
Last Update Date
19 November 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4093444466
Graduation Year
2020 (6 years ago)
PAC ID
5698188712
Group Practice PAC ID
6305875923
Professional Enrollment ID
I20210111001527
Address ID
TX776274145NE1132XAVEX300

Contacts

Other Endpoint
Kareo
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

22,204 NURSE PRACTITIONER in TX

Provider Addresses for BRENT LANE MAZZAGATE

  • 1003 NEDERLAND AVE

    NEDERLAND, TX 776272832

    Phone: (409) 344-4466

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-01-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210111001527INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes4842$0
90674Influenza vaccine, quadrivalent derived from cell cultures, preservative and antibiotic free3333$0
G0008Administration of influenza virus vaccine2525$0
99348Residence visit for established patient with low level of medical decision making, per day, if using time, at least 30 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 77627)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6305875923View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Pediatric Medicine, Internal MedicineTX

Reviews

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Frequently asked questions

Can I cross-check BRENT LANE MAZZAGATE using NPI 1952904104?
NPI 1952904104 belongs to BRENT LANE MAZZAGATE; compare other details if you need extra assurance.
Is BRENT LANE MAZZAGATE shown as active in public data?
Registry records indicate BRENT LANE MAZZAGATE maintains an active NPI.
What expertise is attributed to BRENT LANE MAZZAGATE?
BRENT LANE MAZZAGATE's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is BRENT LANE MAZZAGATE located near Nederland?
BRENT LANE MAZZAGATE currently maps to Nederland, Texas in this extract.
Can I trust this NPI listing for BRENT LANE MAZZAGATE?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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