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NICOLE LAUREN DEPOLO MD
NPI 1164080636
Surgery in Loma Linda, CA

Active since May 30, 2019PECOS Enrolled
11234 ANDERSON ST, LOMA LINDA, CA 92354(909) 558-2822 Get Directions Write a Review

NPPES record last updated: May 9, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 9, 2026, May 14, 2025, Jun 26, 2024 and 1 more (4 updates tracked since 2019).

About Nicole Lauren Depolo Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE LAUREN DEPOLO MD (NPI 1164080636) is an individual surgery provider in Loma Linda, California, licensed in Maryland (D0103262) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Johns Hopkins Hospital, The, and maintains a secondary practice location in Baltimore.

NPPES Registry Identity

NPI1164080636
Entity TypeIndividualFemale
Primary Taxonomy208600000X
Provider Legal NameNICOLE LAUREN DEPOLOCredential: MD
Location Address11234 ANDERSON STLoma Linda, CA 92354-2804
Mailing Address6201 Greenleigh Ave Fl 2Middle River, MD 21220-2004 · (410) 933-0000 · Fax (410) 500-4266
Phone(909) 558-2822
Sole ProprietorNo
Medical School CMSGeorge Washington University School Of MedicineGraduated 2019
Enumeration DateMay 30, 2019
Last NPPES UpdateMay 9, 20264 updates tracked since enumeration
NPPES CertifiedMay 9, 2026
✔ NPI 1164080636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in MD · D0103262
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
11234 ANDERSON ST, Loma Linda, CA 92354
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Secondary Practice Location 1

Location 11800 Orleans StBaltimore, MD 21287-0010 · Phone (410) 955-8893

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Lauren Depolo Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032654520
PECOS Enrollment IDI20250605000251
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Johns Hopkins Hospital, The

Acute Care Hospitals · Baltimore, MD
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210009
Location600 North Wolfe StreetBaltimore, MD 21287 · Baltimore City County
Emergency services Birthing friendly

Johns Hopkins Bayview Medical Center

Acute Care Hospitals · Baltimore, MD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number210029
Location4940 Eastern AvenueBaltimore, MD 21224 · Baltimore City County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92354 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$91.88 typical visit price
range $59.60 – $179.42
Typical copayment $22.97 (range $14.90 – $44.85)
Most-billed visit code 99203
Established Patient
$74.08 typical visit price
range $19.37 – $146.42
Typical copayment $18.52 (range $4.84 – $36.60)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

ELYSE LAUREN GURAN
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4015
SAMUEL COOK CHAMBI
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4015
LUIS MIGUEL OLMEDO TEMICH MD
General Practice
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-2822
HYUKJE SUNG MD, MA
Preventive Medicine (Occupational Medicine)
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-6491
JEFFERSON BRANCH RICHARDS
Student in an Organized Health Care Education/Training Program
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4074
JOSEPH UNIS M.D.
Radiology (Diagnostic Radiology)
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-8311
MARINA LIU M.D.
Anesthesiology
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4475
JOSEPH M WILKINSON CRNA
Nurse Anesthetist, Certified Registered
11234 ANDERSON ST
LOMA LINDA, CA 92354
San Bernardino County (909) 558-4475

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 Nicole Depolo's NPI number?

The NPI number for Nicole Depolo is 1164080636. It was assigned to this individual provider in the NPPES registry on May 30, 2019.

Where is Nicole Depolo located?

Nicole Depolo practices at 11234 Anderson St, Loma Linda, CA 92354. The listed phone number is (909) 558-2822.

What is Nicole Depolo's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Nicole Depolo enrolled in Medicare?

Yes. Nicole Depolo is registered in the Medicare PECOS enrollment system.

Is Nicole Depolo affiliated with any hospitals?

According to CMS data, Nicole Depolo is affiliated with Johns Hopkins Hospital, The and Johns Hopkins Bayview Medical Center.

When was this NPI record last updated?

The NPPES record for Nicole Depolo was last updated on May 9, 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.