Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alyssa L. Detommaso, PA-C

Individual provider Physician Assistant · NPI 1801339791

Alyssa L. Detommaso, PA-C is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2016, 10 years ago. Practices with Lutheran Medical Group LLC, a 250-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
10
Licensed in
IN
In the registry since
2016
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2516 E Dupont Rd
Fort Wayne, IN 46825-1608
Phone: (260) 458-3050
Fax: (260) 479-4621
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10002198A (IN)

Record details

NPI number1801339791
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 23, 2016
Last updated in NPPESOctober 13, 2025
Certification dateOctober 13, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Lutheran Medical Group Llc — 250 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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