Active NPI 1235631557 Individual Practitioner Male Practitioner

Samuel Vincent Dismuke , PA-C

Physician Assistant • Fort Wayne, IN

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Samuel Dismuke, PA-C is a certified Physician Assistant practicing in Fort Wayne, IN. With approximately 9 years of clinical experience since completing medical education in 2017, Samuel Dismuke delivers high-quality medical care to the local community at 5050 N CLINTON ST.

Samuel Dismuke maintains professional affiliations with Orthopaedics Northeast Pc, Summit Radiology P C and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, methylprednisolone acetate, 1 mg, fusion of additional segment of spine, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

5050 N Clinton St

Fort Wayne, IN 468255886

Telephone 2604848551

Fax 2604825060

Associated Practice Facility / Clinic

🏢 Orthopaedics Northeast Pc Facility NPI 1740268796

Medicare Profile & Education

Medical School

Other

Graduation Year

2017

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Fort Wayne, IN

Experienced Practitioner (5-10 Yrs)

Practitioner Clinical Experience

9 Yrs -1.4 yrs vs City Avg

City Avg: 10.4 Yrs

State Avg: 9.4 Yrs

Regional Practice Density

315 Specialists

Practicing in Fort Wayne, IN (2429 Statewide)

Telehealth Adoption Rate

7.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

95.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Dismuke (9 Years) 9 Yrs

Fort Wayne Specialty Average (10.4 Years) 10.4 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J1010 Injection, methylprednisolone acetate, 1 mg	1,050	15	$6.51	$0.12
22614 Fusion of additional segment of spine	66	15	$1067.17	$46.10
99213 Established patient office or other outpatient visit, typically 15 minutes	58	54	$249.00	$68.60
72100 X-ray of lower and sacral spine, 2-3 views	42	32	$118.00	$29.99
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	39	26	$668.23	$30.43
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	25	24	$147.00	$44.40
72040 X-ray of upper spine, 2-3 views	20	13	$111.00	$30.70
22612 Fusion of spine in lower back	19	17	$4234.58	$191.18
20552 Injections of trigger points in 1 or 2 muscles	16	15	$190.00	$40.97
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	15	13	$2891.87	$98.12
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	14	14	$3975.00	$98.80
22842 Placement of stabilizing device to back, 3-6 spine bone segments	12	12	$2136.25	$90.12
22845 Placement of stabilizing device to front, 2-3 spine bone segments	12	12	$1885.00	$85.45

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	81	68	$249.00	$70.43
22614 Fusion of additional segment of spine	72	19	$1025.04	$46.71
72100 X-ray of lower and sacral spine, 2-3 views	66	54	$118.00	$30.99
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	46	25	$657.00	$30.86
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	36	$147.00	$44.48
72040 X-ray of upper spine, 2-3 views	27	18	$111.00	$29.95
22585 Fusion of spine bones through front of body with partial removal of disc, each additional disc	21	11	$852.00	$39.07
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	18	18	$3975.00	$113.68
22612 Fusion of spine in lower back	18	18	$4091.00	$187.43
J1040 Injection, methylprednisolone acetate, 80 mg	17	13	$42.00	$11.59
20552 Injections of trigger points in 1 or 2 muscles	16	15	$190.00	$41.48
22842 Placement of stabilizing device to back, 3-6 spine bone segments	16	16	$1972.00	$91.22
22845 Placement of stabilizing device to front, 2-3 spine bone segments	12	12	$1885.00	$86.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
22614 Fusion of additional segment of spine	95	20	$992.00	$47.53
72100 X-ray of lower and sacral spine, 2-3 views	90	67	$116.00	$31.07
99213 Established patient office or other outpatient visit, typically 15 minutes	85	76	$244.00	$70.88
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	60	30	$644.00	$31.29
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	46	38	$144.00	$44.35
22612 Fusion of spine in lower back	19	19	$4011.00	$195.34
63048 Partial removal of spine bone with release of spinal cord and/or nerves	19	12	$536.00	$25.64
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	18	18	$3897.00	$109.86
22842 Placement of stabilizing device to back, 3-6 spine bone segments	17	17	$1933.00	$92.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	16	16	$361.00	$84.61
72040 X-ray of upper spine, 2-3 views	15	13	$109.00	$31.06
22845 Placement of stabilizing device to front, 2-3 spine bone segments	13	12	$1848.00	$88.04
72020 X-ray of spine, 1 view	12	12	$73.00	$19.34
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	11	11	$2774.00	$117.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	81	73	$222.00	$71.32
72100 X-ray of lower and sacral spine, 2-3 views	76	57	$105.00	$30.77
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	72	60	$131.00	$44.10
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	62	33	$586.00	$31.47
22614 Fusion of additional segment of spine	56	18	$902.00	$48.28
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	23	23	$3594.35	$121.55
72040 X-ray of upper spine, 2-3 views	23	21	$99.00	$31.09
22845 Placement of stabilizing device to front, 2-3 spine bone segments	20	20	$1680.00	$89.67
22612 Fusion of spine in lower back	20	20	$3707.75	$190.22
22585 Fusion of spine bones through front of body with partial removal of disc, each additional disc	20	12	$760.00	$40.48
63048 Partial removal of spine bone with release of spinal cord and/or nerves	19	14	$487.00	$26.06
22842 Placement of stabilizing device to back, 3-6 spine bone segments	16	16	$1757.00	$94.18
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	12	12	$2522.00	$108.70

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
72100 X-ray of lower and sacral spine, 2-3 views	79	57	$103.00	$30.12
99213 Established patient office or other outpatient visit, typically 15 minutes	71	59	$218.00	$57.81
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	56	28	$575.00	$32.39
22614 Fusion of additional segment of spine	48	19	$884.00	$49.11
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	43	35	$128.00	$36.19
72040 X-ray of upper spine, 2-3 views	40	25	$97.00	$30.11
22585 Fusion of spine bones through front of body with partial removal of disc, each additional disc	22	12	$745.00	$41.27
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	19	18	$3473.00	$117.43
22842 Placement of stabilizing device to back, 3-6 spine bone segments	18	18	$1723.00	$95.56
22612 Fusion of spine in lower back	17	17	$3575.00	$200.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	13	13	$322.00	$87.59

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
72100 X-ray of lower and sacral spine, 2-3 views	86	62	$100.00	$28.52
99213 Established patient office or other outpatient visit, typically 15 minutes	74	64	$213.00	$58.73
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	64	35	$560.00	$30.32
22614 Fusion of additional segment of spine	53	25	$862.00	$46.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	35	$125.00	$35.74
22585 Fusion of spine bones through front of body with partial removal of disc, each additional disc	25	16	$727.00	$37.29
22842 Placement of stabilizing device to back, 3-6 spine bone segments	24	23	$1681.00	$90.12
72040 X-ray of upper spine, 2-3 views	23	18	$95.00	$28.74
63048 Partial removal of spine bone with release of spinal cord and/or nerves	21	14	$465.00	$26.00
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	21	21	$3389.00	$119.22
22612 Fusion of spine in lower back	18	18	$3488.00	$188.63
63047 Partial removal of middle spine bone with release of spinal cord and/or nerves	17	17	$2412.00	$98.73
20937 Harvest of bone fragment for spine bone graft	17	17	$371.00	$20.79
22845 Placement of stabilizing device to front, 2-3 spine bone segments	15	15	$1607.00	$83.51
99221 Initial hospital inpatient care per day, typically 30 minutes	15	15	$299.00	$80.83
22551 Fusion of upper spine bone with removal of disc and release of spinal cord or nerve, 1 disc	13	13	$3742.00	$208.96
22633 Fusion of spine in lower back with partial removal of spine bone and disc	11	11	$4153.36	$228.24

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
22853 Insertion of cage or mesh device to spine bone and disc space during spine fusion	48	22	$549.00	$31.31
22614 Fusion of additional segment of spine	27	11	$845.00	$48.18
22558 Fusion of spine bones with removal of disc at lower spinal column, anterior approach	11	11	$3322.00	$104.06
22612 Fusion of spine in lower back	11	11	$3420.00	$187.74

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IN 10002437A

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

300013242 (IN)

Hospital & Practice Group Affiliations

Summit Radiology P C

None, Fort Wayne, IN 46835

Phone: 2604321568

Orthopaedics Northeast Pc

5050 N Clinton St, Fort Wayne, IN 468255886

Phone: 2604848551

Orthopaedics Northeast Pc

11136 Parkview Circle Dr, Fort Wayne, IN 468451730

Phone: 2604848551

Orthopaedics Northeast Pc

8202 Glencarin Blvd, Fort Wayne, IN 468045783

Phone: 2604848551

Secondary Practice Locations

1500 Provident Dr Ste B

Warsaw, IN 465803297

Phone: 5742698301

11136 Parkview Circle Dr

Fort Wayne, IN 468451730

Phone: 2604848551

7920 W Jefferson Blvd

Fort Wayne, IN 468044168

Phone: 2604848551

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners

Anthony Dzigbordi

Nurse Anesthetist, Certified Registered

NPI 1003517954

Abigail Gann , PA

Physician Assistant

NPI 1003639956

Physician Assistant

Lisa Tompa , CRNA

Nurse Anesthetist, Certified Registered

NPI 1013919018

Certified Registered Nurse Anesthetist

Craig Dyer , ATC

Specialist/Technologist - Athletic Trainer

NPI 1013977354

Certified Athletic Trainer

Dr. Sarah Lasalle , DO

Anesthesiology

NPI 1023399128

Doctor of Osteopathic Medicine (D.O.)

Felicia Wehrle

Nurse Practitioner

NPI 1023764990

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events

📍

Updated Practice Location October 30, 2018

Registered at 5050 N CLINTON ST, FORT WAYNE, IN 468255886 (Tel: 2604848551)

👤

Provider Name / Credentials Updated October 30, 2018

Recorded as SAMUEL DISMUKE, PA-C

📍

Updated Practice Location May 31, 2018

Registered at 5050 N CLINTON ST, FORT WAYNE, IN 46825 (Tel: 2604848551)

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 31, 2018

Physician Assistant (License #10002437A in IN)

✅

NPI Profile Active March 02, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location March 02, 2018

Registered at 5050 N CLINTON ST, FORT WAYNE, IN 468255886 (Tel: 2604848551)

📍

Updated Business Mailing Address March 02, 2018

Registered at 5052 N CLINTON ST, FORT WAYNE, IN 468255822 (Tel: 2604848551)

👤

Provider Name / Credentials Updated March 02, 2018

Recorded as SAMUEL DISMUKE

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) March 02, 2018

Physician Assistant

🟢

Initial NPI Registration & Enumeration March 02, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1235631557

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: March 02, 2018

Last Update: October 30, 2018

Sole Proprietor: No

Update or Correct Profile

Mailing Address

5052 N Clinton St

Fort Wayne, IN 468255822

Phone: 2604848551

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.