Adeline Domkam, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F01220784 Issued in CA

Practice address

3031 W March LN Ste 101
Stockton, CA 95219-6568

Phone

(209) 472-7100

NPI assigned

Feb 21, 2022

Sex

Female

Sole proprietor

Yes

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 CA

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Physicians of California Medical Group IncGroup PAC ID 8224945084, 92 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Joseph'S Medical Center of Stockton Hospital, Stockton, CA, CCN 050084

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Team Physicians of California Medical Group Inc

  • Emergency Medicine Physician
  • Delano, CA
  • NPI 1447288345
  Medicare reassignment Care Compare group
• San Francisco Physicians International Medical Group, Inc

  • Emergency Medicine Physician
  • San Ramon, CA
  • NPI 1841220720
  Medicare reassignment

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

• Port City Operating Company, LLC

  • General Acute Care Hospital
  • Stockton, CA
  • NPI 1528190931
  Care Compare affiliation

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1609521301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3031 W MARCH LN STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196568",
            "telephone_number": "209-472-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3031 W MARCH LN STE 101",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952196568",
            "telephone_number": "209-472-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOMKAM",
        "first_name": "ADELINE",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "F01220784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariana E Dominguez
• Ryan Dominguez
• Samantha Dominguez
• Sophia Aaliyah Dominguez
• Jasmine Domino
• Lauryn Donaire
• Donald C. Huang DDS Inc.
• Donald E. Clarke, D.D.S., Inc.
• Donald P Garcia MD Inc
• Donald Wayne Smith

• Family Nurse Practitioner in Stockton, CA
• Providers in Stockton, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2022; 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.