NPIMap

Individual provider Active NPI

Nicole Marie Depace, NP

  • Gerontology Nurse Practitioner
  • Boston, MA
National Provider Identifier
1265749618
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN281476 Issued in MA
Practice address
830 Harrison Ave
Moakley 3Rd FLR
Boston, MA 02118
Phone
(617) 638-6428
Fax
(617) 638-5756
NPI assigned
Sep 7, 2010
Last updated
May 20, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X RN281476 MA Primary

Addresses

Primary practice location

830 Harrison Ave
Moakley 3Rd FLR
Boston, MA 02118

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other practice location 1

801 Massachusetts Avenue
Crosstown 2
Boston, MA 02118
Phone (617) 414-7399

Other identifiers 2

IdentifierTypeStateIssuer
3148626MedicaidNH
110094929AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110627000697 MA Practitioner - Nurse Practitioner 3779761507 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN281476MAMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Seasons Hospice & Palliative Care of Massachusetts, LLC CurrentSince Sep 25, 2024 Accepting new patients
Seasons Medical Group of Massachusetts, PC CurrentSince Sep 25, 2024 Accepting new patients
Evans Medical Foundation, Inc. CurrentSince Feb 1, 2025 Accepting new patients
Beacon Hospice, LLC Past Accepting new patients
Norwell Visiting Nurse Association, Inc Past Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

960 Massachusetts Ave
Ste 2
Boston, MA 02118

20 Burlington Mall Rd
Ste 450
Burlington, MA 01803
Phone (617) 454-0200

1 Edgewater Dr
Ste 103
Norwood, MA 02062
Phone (617) 454-0200

801 Massachusetts Ave
#2
Roxbury, MA 02118
Phone (617) 414-4376

Interoperability endpoints

  • Direct secure messaging: ndepace251612@direct.bmc.masshiway.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1283817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1265749618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVE",
            "address_2": "MOAKLEY 3RD FLR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-6428",
            "fax_number": "617-638-5756"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "801 Massachusetts Avenue",
            "address_2": "Crosstown 2",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "02118",
            "country_code": "US",
            "telephone_number": "617-414-7399",
            "fax_number": "617-414-4676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEPACE",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-07",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN281476",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3148626",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110094929A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.