DR. NICHOLAS BLAKE GREGORY (DO) – Internal Medicine Physician, NPI 1043897051

DR. NICHOLAS BLAKE GREGORY (DO) is a healthcare provider. based in Ann arbor, Michigan. specializing in HOSPICE/PALLIATIVE CARE, INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 5101027953 (MI). The NPI Number for DR. NICHOLAS BLAKE GREGORY (DO) is 1043897051

Main info

Male
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
DR. NICHOLAS BLAKE GREGORY (DO)
NPI
1043897051
Phone
(734) 747-6766
Address
24 FRANK LLOYD WRIGHT DRIVE
Enumeration Date
25 March 2021
Last Update Date
16 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7347128700
Graduation Year
2021 (5 years ago)
PAC ID
4082015623
Group Practice PAC ID
2466351440
Professional Enrollment ID
I20240612004321
Address ID
MI483415009PO44428AVEX312
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:5State licenses:1Digital endpointsOther names

164 HOSPICE/PALLIATIVE CARE in MI

Provider Addresses for DR. NICHOLAS BLAKE GREGORY (DO)

  • 24 FRANK LLOYD WRIGHT DRIVE

    SUITE J2000

    ANN ARBOR, MI 48105

    Phone: (734) 747-6766

    Type: Mailing

  • IHA HOSPITAL MEDICINE SERVICES

    5301 E HURON RIVER DRIVE

    YPSILANTI, MI 48197

    Phone: (734) 712-8676

    Type: Location

  • 1615 LAKE LANSING RD

    HASLETT, MI 488408426

    Phone: (517) 285-9982

    Type: Mailing

  • 5333 MCAULEY DR RM 4001

    YPSILANTI, MI 481971099

    Phone: (734) 712-3980

    Type: Location

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: 2024-06-12

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
I20240612004321IHospice/Palliative CareMITBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48105)

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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: 2466351440View full group profile
NameSpecialtyState
Hospitalist, Internal MedicineMI
Interventional RadiologyMI
Cardiovascular Disease (Cardiology)MI
Physician AssistantMI
Physician AssistantMI
-MI
-MI
Internal Medicine, Geriatric MedicineMI
O B S T E T R I C S/ G Y N E C O L O G YMI
Hospitalist, Internal MedicineMI

Reviews

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Frequently asked questions

Can I use this page to confirm DR. NICHOLAS BLAKE GREGORY (DO)'s NPI?
Yes. DR. NICHOLAS BLAKE GREGORY (DO) is listed with NPI 1043897051 in the public NPI dataset.
Can I rely on DR. NICHOLAS BLAKE GREGORY (DO) being an active provider?
As of the registry snapshot, DR. NICHOLAS BLAKE GREGORY (DO) is marked active.
What is DR. NICHOLAS BLAKE GREGORY (DO)'s primary classification?
Internal Medicine Physician is the headline specialty for DR. NICHOLAS BLAKE GREGORY (DO) here. Clinical services aligned with this taxonomy classification.
What address line appears for DR. NICHOLAS BLAKE GREGORY (DO)?
DR. NICHOLAS BLAKE GREGORY (DO)'s geographic hint is Ann Arbor, Michigan in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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