SAMUEL VINCENT DISMUKE PA-C
NPI 1235631557
Physician Assistant in Fort Wayne, IN

Q: What is Samuel Dismuke's NPI number?

The NPI number for Samuel Dismuke is 1235631557. It was assigned to this individual provider in the NPPES registry on March 2, 2018.

Q: What is Samuel Dismuke's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Samuel Dismuke was last updated on October 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since March 02, 2018PECOS EnrolledAccepts Medicare Assignment

5050 N CLINTON ST, FORT WAYNE, IN 46825(260) 484-8551(260) 482-5060 Get Directions Write a Review

NPPES record last updated: October 30, 2018. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Oct 30, 2018, Oct 24, 2018, Mar 2, 2018 (3 updates tracked since 2018).

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About Samuel Vincent Dismuke Pa-c NPPES

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

SAMUEL VINCENT DISMUKE PA-C (NPI 1235631557) is an individual physician assistant in Fort Wayne, Indiana, licensed in Indiana (10002437A) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS, is affiliated with Lutheran Hospital Of Indiana, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1235631557

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameSAMUEL VINCENT DISMUKECredential: PA-C

Location Address5050 N CLINTON STFort Wayne, IN 46825-5886

Mailing Address5052 N Clinton StFort Wayne, IN 46825-5822 · (260) 484-8551 · Fax (260) 482-5060

Phone(260) 484-8551

Fax(260) 482-5060

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMarch 2, 2018

Last NPPES UpdateOctober 30, 20183 updates tracked since enumeration

✔ NPI 1235631557 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in IN · 10002437A

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.

5050 N CLINTON ST, Fort Wayne, IN 46825

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Other Identifiers 1

Medicaid300013242IN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

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

Samuel Vincent Dismuke 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 ID6709140403

PECOS Enrollment IDI20180504001206

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 12

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.

Fusion of additional segment of spine 22614

Fusion of an additional segment of the spine is a surgical procedure to join two or more vertebrae together. This is done to stabilize the spine and reduce pain or correct a deformity. The procedure involves using bone grafts, rods, or screws to secure the spine.

66 services15 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

58 services54 patients

X-ray of lower and sacral spine, 2-3 views 72100

An X-ray of the lower and sacral spine involves capturing images of your lower back area, including the tailbone. This procedure helps in identifying problems like fractures, infections, or deformities. 2-3 different angle views provide a comprehensive picture.

42 services32 patients

Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853

Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.

39 services26 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

25 services24 patients

X-ray of upper spine, 2-3 views 72040

An X-ray of the upper spine, with 2-3 views, is a painless procedure that employs a small amount of radiation to capture images of your neck and upper back. It assists in diagnosing conditions like arthritis, fractures, or spinal deformities.

20 services13 patients

Fusion of spine in lower back 22612

Fusion of the spine in the lower back, also known as lumbar spinal fusion, is a surgery aimed to join, or fuse, two or more vertebrae in your lower back. This procedure can help alleviate pain and improve stability by reducing movement between the vertebrae.

19 services17 patients

Injection of trigger points, 1-2 muscles 20552

Trigger point injection is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. 1-2 muscles are typically treated in one session. The procedure involves injecting medications into these points to alleviate pain.

16 services15 patients

Partial removal of spine bone with release of lower spinal cord and/or nerves, 1 segment 63047

This procedure involves removing part of a spine bone to alleviate pressure on the lower spinal cord and/or nerves. It targets a single segment of the spine, improving mobility and reducing pain. It's a common treatment for conditions like herniated discs or spinal stenosis.

15 services13 patients

Fusion of lower spine bone through abdomen with partial removal of disc 22558

This procedure involves merging the bones in your lower spine through an abdominal approach. A portion of the disc, which acts like a cushion between your vertebrae, is partially removed. The goal is to alleviate back pain by limiting movement in the problem area of your spine.

14 services14 patients

Placement of stabilizing device to back, 3-6 spine bone segments 22842

This procedure involves placing a device on your back to stabilize 3-6 spine bone segments. It aids in maintaining spine alignment and reducing pain. The device is secured to the bones, providing support and promoting healing.

12 services12 patients

Placement of stabilizing device to front, 2-3 spine bone segments 22845

This procedure involves positioning a stabilizing device on the front of 2-3 segments of your spine. It's designed to provide support and stability to your spine, potentially alleviating discomfort and improving mobility.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Lutheran Hospital Of Indiana

Acute Care Hospitals · Fort Wayne, IN

3/5 CMS rating

OwnershipProprietary

CMS Certification Number150017

Location7950 W Jefferson BlvdFort Wayne, IN 46804 · Allen County

Emergency services Birthing friendly

Orthopaedic Hospital At Parkview North

Acute Care Hospitals · Fort Wayne, IN

OwnershipVoluntary non-profit - Private

CMS Certification Number150167

Location11130 Parkview Circle DrFort Wayne, IN 46845 · Allen County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46825 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.

ANTHONY DZIGBORDI

Nurse Anesthetist, Certified Registered

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 484-8551

ABIGAIL MCKENSEY GANN PA

Physician Assistant

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 484-8551

LISA A TOMPA CRNA

Nurse Anesthetist, Certified Registered

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 484-8551

NATHAN NOTTER P.T.

Physical Therapist

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 471-6202

MR. CRAIG A DYER ATC

Specialist/Technologist (Athletic Trainer)

5050 N CLINTON ST
FT WAYNE, IN 46825

Allen County (260) 484-8551

SARAH ANNE LASALLE D.O.

Anesthesiology

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 484-8551

FELICIA WEHRLE

Nurse Practitioner

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 484-8551

KAY ELIZABETH BROWN

Registered Nurse (Orthopedic)

5050 N CLINTON ST
FORT WAYNE, IN 46825

Allen County (260) 408-2035

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 Samuel Dismuke's NPI number?

The NPI number for Samuel Dismuke is 1235631557. It was assigned to this individual provider in the NPPES registry on March 2, 2018.

Where is Samuel Dismuke located?

Samuel Dismuke practices at 5050 N Clinton St, Fort Wayne, IN 46825. The listed phone number is (260) 484-8551.

What is Samuel Dismuke's specialty?

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

Is Samuel Dismuke enrolled in Medicare?

Yes. Samuel Dismuke 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.

What insurance does Samuel Dismuke accept?

Health plans from CareSource list Samuel Dismuke as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Samuel Dismuke affiliated with any hospitals?

According to CMS data, Samuel Dismuke is affiliated with Lutheran Hospital Of Indiana and Orthopaedic Hospital At Parkview North.

When was this NPI record last updated?

The NPPES record for Samuel Dismuke was last updated on October 30, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.