Individual provider Active NPI

Connor Coltharp, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1053039560
Registry record updated Oct 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19289 Issued in TX
Practice address
1201 W 38TH St
Austin, TX 78705-1006
Phone
(512) 324-3028
NPI assigned
Aug 19, 2022
Last updated
Oct 1, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19289 TX Primary

Addresses

Primary practice location

1201 W 38TH St
Austin, TX 78705-1006

Mailing address

1601 Trinity St
Austin, TX 78712-1765
Phone (512) 324-9999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241010002063 MD Practitioner - Physician Assistant 6608308051 Reassigns benefits to 1 organization
I20251103001787 TX Practitioner - Physician Assistant 6608308051 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seton Family of DoctorsGroup PAC ID 0941333280, 785 clinicians

Practice addresses (Care Compare)

1301 W 38TH St
Suite 307
Austin, TX 78705-1012
Phone (512) 324-3028

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA19289TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Seton Family of Doctors CurrentSince Sep 1, 2025 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2024 Accepting new patients
Seton Family of Doctors Current Accepting new patients
Seton Family of Doctors CurrentSince Sep 1, 2025 Accepting new patients
Johns Hopkins University CurrentSince Oct 1, 2024 Accepting new patients

Locations

4940 Eastern Ave
Baltimore, MD 21224

600 N Wolfe St
Baltimore, MD 21287

6201 Greenleigh Ave
Middle River, MD 21220
Phone (410) 933-2704

1201 W 38th St
Austin, TX 78705
Phone (512) 324-1058

1301 W 38th St
Ste 307
Austin, TX 78705
Phone (512) 324-3028

1400 N Interstate 35
Ste 300
Austin, TX 78701
Phone (512) 324-8300

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759276800000",
    "number": "1053039560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 TRINITY ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787121765",
            "telephone_number": "512-324-9999",
            "fax_number": "512-831-5516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 38TH ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787051006",
            "telephone_number": "512-324-3028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLTHARP",
        "first_name": "CONNOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2025-10-01",
        "certification_date": "2025-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.