MR. BLAKE BAKER NICHOLSON III LCSW
NPI 1891769261
Social Worker - Clinical in Greeley, CO
About Mr. Blake Baker Nicholson Iii Lcsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. BLAKE BAKER NICHOLSON III LCSW (NPI 1891769261) is an individual clinical provider in Greeley, Colorado, licensed in Colorado (992906) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (1998).
NPPES Registry Identity
Specialties & Licenses
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
Mr. Blake Baker Nicholson Iii Lcsw 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 Nicholson reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Loveland, CO 80538
- Reassigned Medicare billing, Colorado enrollment
- 2,596 clinicians in this Medicare group
Boulder, CO 80303
- Reassigned Medicare billing, Colorado enrollment
- Medicare enrollment name: Joseph Yeretsian PC
- 21 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.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 80631 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Nicholson's NPI number?
The NPI number for Blake Nicholson is 1891769261. It was assigned to this individual provider in the NPPES registry on February 14, 2006.
Where is Blake Nicholson located?
Blake Nicholson practices at 928 12th St, Greeley, CO 80631. The listed phone number is (970) 336-4910.
What is Blake Nicholson's specialty?
The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.
Is Blake Nicholson enrolled in Medicare?
Yes. Blake Nicholson 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 Nicholson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Blake Nicholson reassigns Medicare benefits to 2 organizations: Poudre Valley Medical Group, LLC (Loveland, CO) and Joseph Yeretsian, P.C. (Boulder, CO). 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 Nicholson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Blake Nicholson accept?
Health plans from Select Health list Blake Nicholson 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.
When was this NPI record last updated?
The NPPES record for Blake Nicholson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months 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.
# Mr. Blake Baker Nicholson III, LCSW · NPI 1891769261
Clinical provider in Greeley, Colorado. Individual provider, active in the CMS NPPES registry since February 14, 2006.
## Identity
- **NPI:** 1891769261 (Entity type: Individual)
- **Enumerated:** February 14, 2006
- **Primary specialty:** Social Worker - Clinical · taxonomy 1041C0700X
- **State license:** 992906 (Colorado)
- **Sole proprietor:** No
## Practice location
- **Address:** 928 12TH ST, Greeley, CO 80631-4024
- **Phone:** (970) 336-4910 · **Fax:** (970) 336-5000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Poudre Valley Medical Group, LLC (NPI 1366763260, Loveland, CO); Joseph Yeretsian, P.C. (NPI 1942668165, Boulder, CO) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Kansas School Of Med, class of 1998
## Record status
- **NPPES last updated:** July 13, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1891769261) · Data from the CMS NPPES public registry.