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

Samuel Vincent Dismuke, PA-C

Individual provider Physician Assistant · NPI 1235631557

Samuel Vincent Dismuke, PA-C is a Physician Assistant in Fort Wayne, Indiana. Qualified in 2017, 9 years ago. Practices with Summit Radiology P C, a 102-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
9
Licensed in
IN
In the registry since
2018
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

5050 N Clinton St
Fort Wayne, IN 46825-5886
Phone: (260) 484-8551
Fax: (260) 482-5060
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 7920 W Jefferson Blvd, Fort Wayne, IN 46804-4168 — (260) 484-8551
  • 11136 Parkview Circle Dr, Fort Wayne, IN 46845-1730 — (260) 484-8551
  • 1500 Provident Dr Ste B, Warsaw, IN 46580-3297 — (574) 269-8301

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10002437A (IN)

Record details

NPI number1235631557
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedMarch 2, 2018
Last updated in NPPESOctober 30, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Summit Radiology P C — 102 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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