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

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: July 19, 2026.

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

  • Individual
  • Male
  • Years of Experience 10
  • Physician Assistant
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About SAMUEL DISMUKE

This page provides the complete NPI Profile along with additional information for Samuel Dismuke, a primary care provider established in Fort Wayne, Indiana with a medical specialization in Physician Assistant and more than 10 years of experience. The healthcare provider is registered in the NPI registry with number 1235631557 assigned on March 2018. The practitioner's primary taxonomy code is 363A00000X with license number 10002437A (IN). The provider is registered as an individual and his NPI record was last updated 8 years ago.

NPI
1235631557 Verify this NPI
Provider Name
SAMUEL VINCENT DISMUKE PA-C
Gender
Male
Entity Type
Individual
Location Address
5050 N CLINTON ST FORT WAYNE, IN 46825
Location Phone
(260) 484-8551
Location Fax
(260) 482-5060
Mailing Address
5052 N CLINTON ST FORT WAYNE, IN 46825
Mailing Phone
(260) 484-8551
Mailing Fax
(260) 482-5060
Medical School Name
OTHER
Graduation Year
2017
Is Sole Proprietor?
No
Enumeration Date
03-02-2018
Last Update Date
10-30-2018
Code Navigator

A primary care provider (PCP) like Samuel Dismuke sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Secondary Locations

  • 1500 Provident Dr Ste B
    Warsaw, IN 46580
    (574) 269-8301
  • 11136 Parkview Circle Dr
    Fort Wayne, IN 46845
    (260) 484-8551
  • 7920 W Jefferson Blvd
    Fort Wayne, IN 46804
    (260) 484-8551

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant

Taxonomy Code
363A00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
10002437A
License State
IN
Taxonomy Description
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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • HDHP Preventive Silver 5500 $0 Chronic Care Drugs - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • HSA Eligible Bronze 6000 - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
300013242MEDICAID (05)IN 

Medicare Participation & PECOS Enrollment Status

Samuel Dismuke is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Samuel Dismuke is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 6709140403

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20180504001206

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

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

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.

This service was performed 58 times for 54 patients

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

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.

This service was performed 25 times for 24 patients

Fusion of additional segment of spine

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.

This service was performed 66 times for 15 patients

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

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.

This service was performed 14 times for 14 patients

Fusion of spine in lower back

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.

This service was performed 19 times for 17 patients

Injection of trigger points, 1-2 muscles

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.

This service was performed 16 times for 15 patients

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

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.

This service was performed 39 times for 26 patients

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

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.

This service was performed 15 times for 13 patients

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

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.

This service was performed 12 times for 12 patients

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

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.

This service was performed 12 times for 12 patients

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

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.

This service was performed 42 times for 32 patients

X-ray of upper spine, 2-3 views

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.

This service was performed 20 times for 13 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.51 for a new patient copayment and $16.62 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 46825 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.04
  • Minimum New Patient Price $53.07
  • Maximum New Patient Price $161.76
  • Average New Patient Copayment $20.51
  • Minimum New Patient Copayment $13.26
  • Maximum New Patient Copayment $40.44

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.48
  • Minimum Established Patient Price $16.93
  • Maximum Established Patient Price $132.22
  • Average Established Patient Copayment $16.62
  • Minimum Established Patient Copayment $4.23
  • Maximum Established Patient Copayment $33.05

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Samuel Dismuke is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
LUTHERAN HOSPITAL OF INDIANA7950 W JEFFERSON BLVD
FORT WAYNE, IN 46804
(260) 435-7001Acute Care Hospitals
ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH11130 PARKVIEW CIRCLE DR
FORT WAYNE, IN 46845
(260) 672-4050Acute Care Hospitals

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Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

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5050 N CLINTON ST
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Specialist/Technologist (Athletic Trainer)
5050 N CLINTON ST
FT WAYNE, IN 46825
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5050 N CLINTON ST
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5050 N CLINTON ST
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FORT WAYNE, IN 46825
Clinic/Center (Physical Therapy)
5050 N CLINTON ST
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Physical Therapist
5050 N CLINTON ST
FORT WAYNE, IN 46825
Physical Therapist
5050 N CLINTON ST
FORT WAYNE, IN 46825
Physical Therapist
5050 N CLINTON ST
FORT WAYNE, IN 46825
Physical Therapist
5050 N CLINTON ST
FORT WAYNE, IN 46825
Occupational Therapist
5050 N CLINTON ST
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5050 N CLINTON ST
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Physical Therapist
5050 N CLINTON ST
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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235631557, enumerated as an "individual" on March 02, 2018.

The provider is located at 5050 N CLINTON ST FORT WAYNE, IN 46825 and the phone number is (260) 484-8551.

Physician Assistant with taxonomy code 363A00000X.

The provider might be accepting Accepts: CareSource, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.

Samuel Dismuke is affiliated with: LUTHERAN HOSPITAL OF INDIANA and ORTHOPAEDIC HOSPITAL AT PARKVIEW NORTH.