Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICOLE LAUREN DEPOLO MD
NPI 1164080636
Surgery in Eau Claire, WI

Q: 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.

Q: What is Nicole Depolo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nicole Depolo was last updated on October 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 days 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.

Active since May 30, 2019PECOS Enrolled

1400 BELLINGER ST, EAU CLAIRE, WI 54703(715) 838-5222 Get Directions Write a Review

NPPES record last updated: October 1, 2026. Verified against the NPPES registry weekly; last sync: October 11, 2026.

Record update history: Oct 1, 2026, May 9, 2026, May 14, 2025 and 2 more (5 updates tracked since 2019).

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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 Eau Claire, Wisconsin, licensed in Wisconsin (88199) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with Johns Hopkins Hospital, The, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1164080636

Entity TypeIndividualFemale

Primary Taxonomy208600000X

Provider Legal NameNICOLE LAUREN DEPOLOCredential: MD

Location Address1400 BELLINGER STEau Claire, WI 54703-5222

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (715) 838-5222

Phone(715) 838-5222

Sole ProprietorNo

Medical School CMSGeorge Washington University School Of MedicineGraduated 2019

Enumeration DateMay 30, 2019

Last NPPES UpdateOctober 1, 20265 updates tracked since enumeration

NPPES CertifiedOctober 1, 2026

✔ NPI 1164080636 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians

Taxonomy Code208600000X

Licenses✔ Licensed in WI · 88199✔ 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.

1400 BELLINGER ST, Eau Claire, WI 54703

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Secondary Practice Locations 2

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

Location 211234 Anderson StLoma Linda, CA 92354-2804 · Phone (909) 558-2822

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 54703 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

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.

ELLEN A CHRISTENSEN OT

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