Mr Tyler Stephen Clutter, PA-C in Mishawaka, IN

Mr Tyler Stephen Clutter, PA-C is a medicare enrolled "Physician Assistant - Medical" in Mishawaka, Indiana. His current practice location is 5215 Holy Cross Pkwy, Mishawaka, Indiana. You can reach out to his office (for appointments etc.) via phone at (574) 523-3160.

Mr Tyler Stephen Clutter is licensed to practice in Indiana (license number 10003930A) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679285993.

Contact Information

	Mr Tyler Stephen Clutter, PA-C
	5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469
	(574) 523-3160
	(574) 523-3221

Map and Direction

Provider's Profile

Full Name	Mr Tyler Stephen Clutter
Gender	Male
Speciality	Physician Assistant - Medical
Location	5215 Holy Cross Pkwy, Mishawaka, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1679285993
Provider Enumeration Date: 12/19/2022
Last Update Date: 04/08/2025

Medicare PECOS Information:

PECOS PAC ID: 9830562537
Enrollment ID: I20230228001235

Medical Identifiers

Medical identifiers for Mr Tyler Stephen Clutter such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679285993	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	(* (Not Available))	Secondary
363AM0700X	Physician Assistant - Medical	10003930A (Indiana)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Tyler Stephen Clutter is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr Tyler Stephen Clutter, PA-C 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 Ph: (574) 523-3160	Mr Tyler Stephen Clutter, PA-C 5215 Holy Cross Pkwy, Mishawaka, IN 46545-1469 Ph: (574) 523-3160

Reviews and Comments

Physician Assistant Nurses in Mishawaka, IN

Megan Michelle Poole, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-335-5000
Collins Abere, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545 Phone: 574-335-5000
Mrs. Diana E Perez - Solano, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 611 E Douglas Rd Ste 207, Mishawaka, IN 46545 Phone: 574-335-6850 Fax: 574-335-0849
Emily Elston, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 505 W Cleveland Rd, Mishawaka, IN 46545 Phone: 574-235-3135
Emily Grace Gouker, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 270 E Day Rd Ste 280, Mishawaka, IN 46545 Phone: 574-271-0268 Fax: 574-271-0395
Mrs. Tanya Christina Vogt, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 250 E. Day Road, Suite 360, Mishawaka, IN 46545 Phone: 574-313-2933 Fax: 574-313-8690

Mr Tyler Stephen Clutter, PA-C - Medicare Physician Assistant in Mishawaka, IN