ADELINE DOMKAM FNP
NPI 1609521301
Nurse Practitioner - Family in Stockton, CA
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
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Adeline Domkam Fnp is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
2Medicare enrollment records show Adeline Domkam reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
San Ramon, CA 94583
- Reassigned Medicare billing, California enrollment
- 168 clinicians in this Medicare group
Delano, CA 93215
- Reassigned Medicare billing, California enrollment
- 301 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
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.
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 system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Adeline Domkam's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Adeline Domkam reassigns Medicare benefits to 2 organizations: San Francisco Physicians International Medical Group, Inc (San Ramon, CA) and Team Physicians Of California Medical Group Inc (Delano, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Adeline Domkam's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
# Adeline Domkam, FNP · NPI 1609521301
Family physician in Stockton, California. Individual provider, active in the CMS NPPES registry since February 21, 2022.
## Identity
- **NPI:** 1609521301 (Entity type: Individual)
- **Enumerated:** February 21, 2022
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** F01220784 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3031 W MARCH LN STE 101, Stockton, CA 95219-6568
- **Phone:** (209) 472-7100
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): San Francisco Physicians International Medical Group, Inc (NPI 1841220720, San Ramon, CA); Team Physicians Of California Medical Group Inc (NPI 1447288345, Delano, CA) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** February 21, 2022
---
Source: [NPI Profile](https://npiprofile.com/npi/1609521301) · Data from the CMS NPPES public registry.