BLAKE E NICHOLS (M.D.) – Pediatric Critical Care Medicine Physician, NPI 1144583469
Pediatric Critical Care Medicine Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
2,256 PEDIATRIC MEDICINE in TX
Provider Addresses for BLAKE E NICHOLS (M.D.)
1935 MEDICAL DISTRICT DR
DALLAS, TX 752357701
Phone:
Type: Mailing
PO BOX 733784
DALLAS, TX 753733784
Phone: (682) 885-6483
Fax: (682) 885-3113
Type: Mailing
801 7TH AVE
FORT WORTH, TX 761042733
Phone: (682) 885-7942
Fax: (682) 885-7956
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: 2018-08-09
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180809000630 | I | Pediatric Medicine | TX | TBD |
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.
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 75235)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pediatric Medicine, Cardiac Electrophysiology | TX | |
| - | OK | |
| - | TX | |
| H O S P I T A L I S T | VA | |
| - | TX | |
| - | TX | |
| - | TX | |
| Pulmonary Disease, Pediatric Medicine | TX | |
| - | TX | |
| Certified Registered Nurse Anesthetist (Crna) | TX |
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