ETHYN DUST
NPI 1073499620
Physician Assistant in Fort Wayne, IN

Active since August 11, 2025PECOS Enrolled
7950 W JEFFERSON BLVD, FORT WAYNE, IN 46804(260) 435-7001 Get Directions Write a Review

NPPES record last updated: August 11, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ethyn Dust NPPES

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

ETHYN DUST (NPI 1073499620) is an individual physician assistant in Fort Wayne, Indiana and active in the NPI registry since August 2025. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1073499620
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameETHYN DUST
Location Address7950 W JEFFERSON BLVDFort Wayne, IN 46804-4140
Mailing Address7705 Tipperary TrlFort Wayne, IN 46815-8137 · (217) 690-8385
Sole ProprietorNo
Enumeration DateAugust 11, 2025
NPPES CertifiedAugust 11, 2025
NPI 1073499620 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.

7950 W JEFFERSON BLVD, Fort Wayne, IN 46804

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Ethyn Dust is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 46804 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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.

Other Providers at the Same Location NPPES 20

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

Internal Medicine
7950 W JEFFERSON BLVD, 1ST FLOOR
FORT WAYNE, IN 46804
Emergency Medicine
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Personal Emergency Response Attendant
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Emergency Medicine (Emergency Medical Services)
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Pathology (Anatomic Pathology & Clinical Pathology)
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Emergency Medicine
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Emergency Medicine
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
Emergency Medicine
7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1073499620, enumerated as an "individual" on August 11, 2025.

The provider is located at 7950 W JEFFERSON BLVD FORT WAYNE, IN 46804 and the phone number is (260) 435-7001.

Physician Assistant with taxonomy code 363A00000X.