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

Ethyn Dust

Individual provider Physician Assistant · NPI 1073499620

Ethyn Dust is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2025, 1 year ago. Practices with Emergency Professionals of Indiana PC, a 120-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
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Practice location Address checks out

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone: (260) 435-7001
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1073499620
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 11, 2025
Last updated in NPPESAugust 11, 2025
Certification dateAugust 11, 2025
Mailing address7705 Tipperary Trl, Fort Wayne, IN 46815-8137

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Emergency Professionals Of Indiana Pc — 120 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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