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ADELINE DOMKAM FNP
NPI 1609521301
Nurse Practitioner - Family in Stockton, CA

Active since February 21, 2022PECOS Enrolled
3031 W MARCH LN STE 101, STOCKTON, CA 95219(209) 472-7100 Get Directions Write a Review

NPPES record last updated: February 21, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Adeline Domkam Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ADELINE DOMKAM FNP (NPI 1609521301) is an individual family provider in Stockton, California, licensed in California (F01220784) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2021).

NPPES Registry Identity

NPI1609521301
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameADELINE DOMKAMCredential: FNP
Location Address3031 W MARCH LN STE 101Stockton, CA 95219-6568
Mailing Address3031 W March Ln Ste 101Stockton, CA 95219-6568 · (209) 472-7100
Phone(209) 472-7100
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateFebruary 21, 2022
NPPES CertifiedFebruary 21, 2022
✔ NPI 1609521301 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in CA · F01220784
3031 W MARCH LN STE 101, Stockton, CA 95219
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Adeline Domkam Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3173007705
PECOS Enrollment IDI20260323000976
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95219 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDMUND CO YAO M.D.
Internal Medicine
3031 W MARCH LN STE 101
STOCKTON, CA 95219
San Joaquin County (209) 472-7100
EDMUND YAO MD INC
Internal Medicine
3031 W MARCH LN STE 101
STOCKTON, CA 95219
San Joaquin County (209) 472-7100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Adeline Domkam's NPI number?

The NPI number for Adeline Domkam is 1609521301. It was assigned to this individual provider in the NPPES registry on February 21, 2022.

Where is Adeline Domkam located?

Adeline Domkam practices at 3031 W March Ln Ste 101, Stockton, CA 95219. The listed phone number is (209) 472-7100.

What is Adeline Domkam's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Adeline Domkam enrolled in Medicare?

Yes. Adeline Domkam is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Adeline Domkam was last updated on February 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.