NICOLE LAUREN DEPOLO MD
NPI 1164080636
Surgery in Loma Linda, CA
NPI Status: Active since May 30, 2019
Contact Information
11234 ANDERSON ST
LOMA LINDA, CA
ZIP 92354
Phone: (909) 558-2822
Some details in this NPI profile have been updated in the NPI registry within the last 30 days.
- Individual
- Female
- Years of Experience 7
- Surgery
- May Accept Medicare Approved Payment
- PECOS Enrolled
About NICOLE DEPOLO
This page provides the complete NPI Profile along with additional information for Nicole Depolo, a provider established in Loma Linda, California with a medical specialization in Surgery and more than 7 years of experience. She graduated from George Washington University School Of Medicine in 2019. The healthcare provider is registered in the NPI registry with number 1164080636 assigned on May 2019. The practitioner's primary taxonomy code is 208600000X with license number D0103262 (MD). The provider is registered as an individual and her NPI record was last updated May 2026.
- NPI
- 1164080636
- Provider Name
- NICOLE LAUREN DEPOLO MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 11234 ANDERSON ST LOMA LINDA, CA 92354
- Location Phone
- (909) 558-2822
- Mailing Address
- 6201 GREENLEIGH AVE FL 2 MIDDLE RIVER, MD 21220
- Mailing Phone
- (410) 933-0000
- Mailing Fax
- Medical School Name
- GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
- Graduation Year
- 2019
- Is Sole Proprietor?
- No
- Enumeration Date
- 05-30-2019
- Last Update Date
- 05-09-2026
- Code Navigator
A surgeon like Nicole Depolo treats injuries, diseases, and deformities through surgical operations. A surgeon could correct physical deformities, repair bone and tissue, or perform preventive or elective surgeries. Surgeons also examine patients, perform and interpret diagnostic tests, and provide counsel on preventive healthcare.
Location Map
Secondary Locations
- 1800 Orleans St
Baltimore, MD 21287
(410) 955-8893
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Surgery
- Taxonomy Code
- 208600000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- D0103262
- License State
- MD
- Taxonomy Description
- 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.
Medicare Participation & PECOS Enrollment Status
Nicole Depolo is registered with Medicare but maybe doesn't accept claims assignment. If you are a Medicare beneficiary call and confirm with the provider before seeking any services.
Nicole Depolo is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 9032654520
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20250605000251
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Maybe
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 92354 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $91.88
- Minimum New Patient Price $59.6
- Maximum New Patient Price $179.42
- Average New Patient Copayment $22.97
- Minimum New Patient Copayment $14.9
- Maximum New Patient Copayment $44.85
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $74.08
- Minimum Established Patient Price $19.37
- Maximum Established Patient Price $146.42
- Average Established Patient Copayment $18.52
- Minimum Established Patient Copayment $4.84
- Maximum Established Patient Copayment $36.6
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicole Depolo is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| JOHNS HOPKINS HOSPITAL, THE | 600 NORTH WOLFE STREET BALTIMORE, MD 21287 | (410) 955-5000 | Acute Care Hospitals | |
| JOHNS HOPKINS BAYVIEW MEDICAL CENTER | 4940 EASTERN AVENUE BALTIMORE, MD 21224 | (410) 550-0123 | Acute Care Hospitals |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1164080636, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 54 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
LOMA LINDA, CA 92354
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1164080636, enumerated as an "individual" on May 30, 2019.
The provider is located at 11234 ANDERSON ST LOMA LINDA, CA 92354 and the phone number is (909) 558-2822.
Surgery with taxonomy code 208600000X.
Nicole Depolo is affiliated with: JOHNS HOPKINS HOSPITAL, THE and JOHNS HOPKINS BAYVIEW MEDICAL CENTER.
