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DOMINIQUE STAY TECKLENBURG PA-C
NPI 1639877475
Physician Assistant in Orem, UT

Active since February 21, 2023PECOS EnrolledAccepts Medicare Assignment

NPPES record last updated: February 21, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dominique Stay Tecklenburg Pa-c NPPES

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

DOMINIQUE STAY TECKLENBURG PA-C (NPI 1639877475) is an individual physician assistant in Orem, Utah and active in the NPI registry since February 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2022).

NPPES Registry Identity

NPI1639877475
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameDOMINIQUE STAY TECKLENBURGCredential: PA-C
Location Address435 S 660 WOrem, UT 84058-6078
Mailing Address435 S 660 WOrem, UT 84058-6078
Phone(801) 691-4980
Sole ProprietorYes
Medical School CMSOtherGraduated 2022
Enumeration DateFebruary 21, 2023
NPPES CertifiedFebruary 21, 2023
✔ NPI 1639877475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
435 S 660 W, Orem, UT 84058
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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 and accepts Medicare assignment

Dominique Stay Tecklenburg Pa-c 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.

PECOS PAC ID3072968668
PECOS Enrollment IDI20231017003888
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.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
36 services32 patients
Subsequent hospital care with straightforward or low level of medical decision making, per day, if using time, at least 25 minutes 99231
Follow-up hospital inpatient care is a daily service where a healthcare professional checks on your health progress during your hospital stay. Each session typically lasts 15 minutes, involving updates on your condition and adjustments to your treatment plan, if necessary.
28 services25 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
26 services26 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
15 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84058 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
$84.41 typical visit price
range $54.34 – $166.03
Typical copayment $21.10 (range $13.58 – $41.50)
Most-billed visit code 99203
Established Patient
$68.01 typical visit price
range $17.23 – $135.20
Typical copayment $17.00 (range $4.30 – $33.80)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Dominique Tecklenburg's NPI number?

The NPI number for Dominique Tecklenburg is 1639877475. It was assigned to this individual provider in the NPPES registry on February 21, 2023.

Where is Dominique Tecklenburg located?

Dominique Tecklenburg practices at 435 S 660 W, Orem, UT 84058. The listed phone number is (801) 691-4980.

What is Dominique Tecklenburg's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Dominique Tecklenburg enrolled in Medicare?

Yes. Dominique Tecklenburg 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.

When was this NPI record last updated?

The NPPES record for Dominique Tecklenburg was last updated on February 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.