1. Home
  2. Directory
  3. Indiana
  4. Mishawaka
  5. Physician Assistant
  6. NPI Profile

MR. TYLER STEPHEN CLUTTER PA-C
NPI 1679285993
Physician Assistant - Medical in Mishawaka, IN

Active since December 19, 2022PECOS Enrolled
5215 HOLY CROSS PKWY, MISHAWAKA, IN 46545(574) 523-3160(574) 523-3221 Get Directions Write a Review

NPPES record last updated: April 8, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 8, 2025, Dec 19, 2022 (2 updates tracked since 2022).

About Mr. Tyler Stephen Clutter Pa-c NPPES

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

MR. TYLER STEPHEN CLUTTER PA-C (NPI 1679285993) is an individual medical provider in Mishawaka, Indiana, licensed in Indiana (10003930A) and active in the NPI registry since December 2022. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679285993
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. TYLER STEPHEN CLUTTERCredential: PA-C
Location Address5215 HOLY CROSS PKWYMishawaka, IN 46545-1469
Mailing Address5215 Holy Cross PkwyMishawaka, IN 46545-1469 · (574) 523-3160 · Fax (574) 523-3221
Phone(574) 523-3160
Fax(574) 523-3221
Sole ProprietorYes
Enumeration DateDecember 19, 2022
Last NPPES UpdateApril 8, 20252 updates tracked since enumeration
NPPES CertifiedApril 8, 2025
✔ NPI 1679285993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License✔ Licensed in IN · 10003930A
5215 HOLY CROSS PKWY, Mishawaka, IN 46545
Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Tyler Stephen Clutter Pa-c 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.

Areas of Expertise CMS Part B claims 2

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.

Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
40 services34 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
30 services30 patients

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.

MINI SRA
Internal Medicine
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-2521
SARA ASHAR DPM
Student in an Organized Health Care Education/Training Program
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-6817
VALORIE ALCOCER RN
Registered Nurse
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-5000
MEGAN MICHELLE POOLE PA-C
Physician Assistant
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-5000
DR. ELIZABETH MARIE LAUBER M.D.
Internal Medicine
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-2521
MRS. MAYRA LINDBORG NP
Nurse Practitioner (Neonatal, Critical Care)
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-4145
MAYELIN LORA-WILLIAMS RD
Dietitian, Registered
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-0001
HEATHER ORT APN
Nurse Practitioner (Family)
5215 HOLY CROSS PKWY
MISHAWAKA, IN 46545
St. Joseph County (574) 335-5000

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 Tyler Clutter's NPI number?

The NPI number for Tyler Clutter is 1679285993. It was assigned to this individual provider in the NPPES registry on December 19, 2022.

Where is Tyler Clutter located?

Tyler Clutter practices at 5215 Holy Cross Pkwy, Mishawaka, IN 46545. The listed phone number is (574) 523-3160.

What is Tyler Clutter's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Tyler Clutter enrolled in Medicare?

Yes. Tyler Clutter is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Tyler Clutter was last updated on April 8, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 months 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.