Nickette Donna Marie Depass-Surgeon, FNP

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

APRN.CPN.0038251 Issued in OH

Practice address

6011 Cleveland Ave Ste B
Columbus, OH 43231-2256

Phone

(614) 966-1690

Fax

(614) 368-0448

NPI assigned

Dec 25, 2024

Last updated

Dec 25, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Kuinmed, LLCGroup PAC ID 3870821036, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Kuinmed LLC

  • Family Nurse Practitioner
  • Columbus, OH
  • NPI 1275082679
  Medicare reassignment Care Compare group NPD
• Health Resolution LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Columbus, OH
  • NPI 1235850462
  NPD

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

{
    "created_epoch": "1735084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735084800000",
    "number": "1861200651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 CLEVELAND AVE STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432312256",
            "telephone_number": "614-966-1690",
            "fax_number": "614-368-0448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 CLEVELAND AVE STE B",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432312256",
            "telephone_number": "614-966-1690",
            "fax_number": "614-368-0448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEPASS-SURGEON",
        "first_name": "NICKETTE",
        "middle_name": "DONNA MARIE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-25",
        "last_updated": "2024-12-25",
        "certification_date": "2024-12-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "OH",
            "license": "APRN.CPN.0038251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Isabella R Depalo
• Department of Mental Retardation and Developmental Disabilities
• Department of Radiology Ohio State University School of Medicine
• Department of Veteran Affairs
• Courtney Nicole Depaso, LSW
• Dependable Home Care LLC
• Dependable Home Health Care LLC
• Deperro Plastic Surgery, LLC
• Michael Phillip Deperro III, M.D.
• Leanna Depizzo, CNP

• Primary Care Nurse Practitioner in Columbus, OH
• Providers in Columbus, OH by specialty
• Primary Care Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.