Tyler Clutter, PA-C
Tyler Clutter, PA-C is a Medical Physician Assistant in Mishawaka, IN, registered under NPI 1679285993. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 5215 HOLY CROSS PKWY, Mishawaka, IN 46545. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 10003930A | IN | Medical Physician Assistant primary |
This provider holds licence 10003930A issued in IN. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
- Status
- Approved
- Provider type
- Practitioner - Physician Assistant
- PAC ID
- 9830562537
- Enrollment ID
- I20230228001235
Medicare enrolment is recorded as approved under the provider type Practitioner - Physician Assistant. Being enrolled means the provider can bill Medicare; it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.
What Medical covers
Definition to come... NUCC Health Care Provider Taxonomy, code 363AM0700X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 363AM0700X | Medical Physician Assistant Medical | 10003930A | IN | primary |
| 363AM0700X | Medical Physician Assistant Medical | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1679285993 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Dec 19, 2022 |
| Last updated | Apr 8, 2025 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | PA-C |
| Practice address |
5215 HOLY CROSS PKWY Mishawaka, IN 46545 (574) 523-3160 Fax (574) 523-3221 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 7 | 9 | 2 | 8 | 5 | 9 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 5 | 9 | 4 | 8 | 1 | 9 | 9 |
Sum = 77 · next multiple of 10 = 80 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.