MARK EDWARD NICHOLS (M.D.) – Obstetrics & Gynecology Physician, NPI 1891780227

MARK EDWARD NICHOLS (M.D.) is a healthcare provider. based in Conroe, Texas. specializing in Obstetrics & Gynecology Physician. They hold the professional credentials M.D.. They hold a License No. L0457 (TX). The NPI Number for MARK EDWARD NICHOLS (M.D.) is 1891780227

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
MARK EDWARD NICHOLS (M.D.)
NPI
1891780227
Phone
(936) 539-4004
Address
605 S CONROE MEDICAL DR
Enumeration Date
12 September 2005
Last Update Date
7 March 2023

Doctor Profile

Medical School Name
UNIVERSITY OF SOUTH CAROLINA SCHOOL OF MEDICINE
Secondary Phone
9365394004
Graduation Year
1993 (33 years ago)
PAC ID
8426094418
Group Practice PAC ID
7416841994
Professional Enrollment ID
I20050629001114
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MARK EDWARD NICHOLS (M.D.)

  • 605, South Conroe Medical Drive, Conroe, Montgomery County, Texas, 77304, United States

    CONROE, TX 773044722

    Phone: (936) 539-4004

    Fax: (936) 539-3635

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2024-10-21 • Largest payer in this snapshot: Baxter Healthcare ($27).

Total Amount

$27

General + Research + Ownership

Payments

1

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-21

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Baxter Healthcare$27
View all Open Payments →|Open Payments Risk Radar →

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: 2005-06-29

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
I20050629001114IObstetrics/GynecologyTXTBD

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 77304)

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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: 7416841994View full group profile
NameSpecialtyState
Family PracticeTX
Mental Health CounselorTX
-TX
Physician AssistantTX
Mental Health CounselorTX
Family PracticeTX
Dermatology, PathologyTX
O B S T E T R I C S/ G Y N E C O L O G YMI
Registered Dietitian Or Nutrition ProfessionalTX
Family PracticeTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARK EDWARD NICHOLS (M.D.)?
MARK EDWARD NICHOLS (M.D.) — NPI 1891780227 — is the standard way to identify this listing.
Does CMS list MARK EDWARD NICHOLS (M.D.) as active?
Yes — MARK EDWARD NICHOLS (M.D.) is active in the NPI listing used on this page.
What is MARK EDWARD NICHOLS (M.D.)'s specialty?
The listing groups MARK EDWARD NICHOLS (M.D.) with Obstetrics & Gynecology Physician. Clinical services aligned with this taxonomy classification.
Where is MARK EDWARD NICHOLS (M.D.) based?
MARK EDWARD NICHOLS (M.D.) is tied to Conroe, Texas in the data we show; additional addresses may exist on the full record.
Why does MARK EDWARD NICHOLS (M.D.) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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