Mr Samuel G Dyste, PA is a medicare enrolled "Physician Assistant - Medical" in East Jordan, Michigan. His current practice location is
601 Bridge St, East Jordan, Michigan. You can reach out to his office (for appointments etc.) via phone at
(231) 536-2206.
Mr Samuel G Dyste is licensed to practice in Michigan (license number 5601005079) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1902098395.
Provider's Profile
Full Name | Mr Samuel G Dyste |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 601 Bridge St, East Jordan, Michigan |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1902098395
- Provider Enumeration Date: 08/10/2007
- Last Update Date: 08/10/2007
Medicare PECOS Information:
- PECOS PAC ID: 7012145113
- Enrollment ID: I20140117001090
Medical Identifiers
Medical identifiers for Mr Samuel G Dyste such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902098395 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363AM0700X | Physician Assistant - Medical | 5601005079 (Michigan) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Samuel G Dyste is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mr Samuel G Dyste, PA 601 Bridge St, East Jordan, MI 49727-9383 Ph: (231) 536-2206 | Mr Samuel G Dyste, PA 601 Bridge St, East Jordan, MI 49727-9383 Ph: (231) 536-2206 |
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