Nicole Depolo, MD in Loma Linda, CA

Nicole Depolo, MD is a medicare enrolled "Surgery" physician in Loma Linda, California. Her current practice location is 11234 Anderson St, Loma Linda, California. You can reach out to her office (for appointments etc.) via phone at (909) 558-2822.

Nicole Depolo is licensed to practice in Maryland (license number D0103262) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1164080636.

Contact Information

	Nicole Depolo, MD
	11234 Anderson St, Loma Linda, CA 92354-2804
	(909) 558-2822
	Not Available

Map and Direction

Physician's Profile

Full Name	Nicole Depolo
Gender	Female
Speciality	Surgery
Location	11234 Anderson St, Loma Linda, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164080636
Provider Enumeration Date: 05/30/2019
Last Update Date: 05/14/2025

Medicare PECOS Information:

PECOS PAC ID: 9032654520
Enrollment ID: I20250605000251

Medical Identifiers

Medical identifiers for Nicole Depolo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164080636	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	D0103262 (Maryland)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Nicole Depolo allows following entities to bill medicare on her behalf.

Entity Name	Johns Hopkins University
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922008549 PECOS PAC ID: 8921903147 Enrollment ID: O20031215000719

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Nicole Depolo is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Nicole Depolo, MD 6201 Greenleigh Ave Fl 2, Middle River, MD 21220-2004 Ph: (410) 933-0000	Nicole Depolo, MD 11234 Anderson St, Loma Linda, CA 92354-2804 Ph: (909) 558-2822

Reviews and Comments

Surgery Doctors in Loma Linda, CA

Dr. Rex Tong Hyun Chung, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 11175 Campus St, Rm 21008, Loma Linda, CA 92350 Phone: 909-558-8131
Sharon S Lum, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St, Suite 2100, Loma Linda, CA 92354 Phone: 909-558-2822
Dr. Hamza Durrani, M.B.B.S. Surgery Medicare: Medicare Enrolled Practice Location: 11234 Anderson St, Loma Linda, CA 92354 Phone: 909-651-9863
Jason A Tomlin, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 11370 Anderson St, Suite 2100, Loma Linda, CA 92354 Phone: 909-558-2822 Fax: 909-558-3905
Laurel Guthrie, Surgery Medicare: Medicare Enrolled Practice Location: 11175 Campus St Ste 21111, Loma Linda, CA 92350 Phone: 909-558-5939
Dr. Richard Lester Yukl, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 24382 Lawton Ave, Loma Linda, CA 92354 Phone: 909-796-6472 Fax: 909-796-6472
Dr. Ryan Anthony Hayton, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 11370 Anderson St, Loma Linda, CA 92354 Phone: 909-558-4000

Nicole Depolo, MD - Medicare Surgery in Loma Linda, CA