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

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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 NameMr Tyler Stephen Clutter
GenderMale
SpecialityPhysician Assistant - Medical
Location5215 Holy Cross Pkwy, Mishawaka, Indiana
Accepts Medicare AssignmentsMedicare 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.
IdentifierTypeStateIssuer
1679285993NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363AM0700XPhysician Assistant - Medical (* (Not Available))Secondary
363AM0700XPhysician Assistant - Medical 10003930A (Indiana)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Tyler Stephen Clutter allows following entities to bill medicare on his behalf.
Entity NameElite Emergency Physicians Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1932155371
PECOS PAC ID: 8022087642
Enrollment ID: O20040930000456
Entity NameCep America LLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1285103671
PECOS PAC ID: 6608056171
Enrollment ID: O20190214000611

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 AddressPractice 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

Azucena Hernandez, PA-C
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Phone: 574-204-7200    
Megan Michelle Poole, PA-C
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Practice Location: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
Phone: 574-335-5000    
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Mrs. Diana E Perez - Solano, PA-C
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Emily Elston, PA-C
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Phone: 574-235-3135    
Gabriela Vettorello,
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Practice Location: 1802 Day Rd, Mishawaka, IN 46545
Phone: 574-204-7200    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.