BLAKE E NICHOLS M.D.
NPI 1144583469
Pediatrics - Pediatric Critical Care Medicine in Fort Worth, TX
About Blake E Nichols M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BLAKE E NICHOLS M.D. (NPI 1144583469) is an individual pediatric critical care medicine provider in Fort Worth, Texas, licensed in Texas (Q4480) and active in the NPI registry since June 2012. He is enrolled in Medicare PECOS, is affiliated with Cook Childrens Medical Center, and is a graduate of University Of Texas Southwestern Medical School At Dallas (2012).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Blake E Nichols M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Blake Nichols reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- Medicare enrollment name: Cook Childrens Physician Network
- 1,186 clinicians in this Medicare group
Fort Worth, TX 76104
- Reassigned Medicare billing, Texas enrollment
- 5,299 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cook Childrens Medical Center
Childrens · Fort Worth, TXMedicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FORT WORTH, TX 76104
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Blake Nichols's NPI number?
The NPI number for Blake Nichols is 1144583469. It was assigned to this individual provider in the NPPES registry on June 21, 2012.
Where is Blake Nichols located?
Blake Nichols practices at 801 7th Ave, Fort Worth, TX 76104. The listed phone number is (682) 885-7942.
What is Blake Nichols's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Critical Care Medicine, with taxonomy code 2080P0203X.
Is Blake Nichols enrolled in Medicare?
Yes. Blake Nichols is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Blake Nichols's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Blake Nichols reassigns Medicare benefits to 2 organizations: Cook Children's Physician Network (Fort Worth, TX) and University Of Texas Southwestern Medical Center At Dallas (Fort Worth, TX). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Blake Nichols's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Blake Nichols accept?
Health plans from Imperial Insurance Companies, Inc. list Blake Nichols as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Blake Nichols affiliated with any hospitals?
According to CMS data, Blake Nichols is affiliated with Cook Childrens Medical Center.
When was this NPI record last updated?
The NPPES record for Blake Nichols was last updated on February 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Blake E Nichols, M.D. · NPI 1144583469
Pediatric Critical Care Medicine physician in Fort Worth, Texas. Individual provider, active in the CMS NPPES registry since June 21, 2012.
## Identity
- **NPI:** 1144583469 (Entity type: Individual)
- **Enumerated:** June 21, 2012
- **Primary specialty:** Pediatrics - Pediatric Critical Care Medicine · taxonomy 2080P0203X
- **State license:** Q4480 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 801 7TH AVE, Fort Worth, TX 76104-2733
- **Phone:** (682) 885-7942 · **Fax:** (682) 885-7956
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Cook Children's Physician Network (NPI 1083472062, Fort Worth, TX); University Of Texas Southwestern Medical Center At Dallas (NPI 1225082050, Fort Worth, TX) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Texas Southwestern Medical School At Dallas, class of 2012
## Record status
- **NPPES last updated:** February 23, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1144583469) · Data from the CMS NPPES public registry.