Individual provider Active NPI

Tyler Clemmons

  • Physician Assistant
  • El Paso, TX
National Provider Identifier
1124854534
Registry record updated Feb 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
18511 Highlander Medics St
El Paso, TX 79906-5327
Phone
(915) 742-7777
NPI assigned
Sep 11, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2026

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 Primary

Addresses

Primary practice location

18511 Highlander Medics St
El Paso, TX 79906-5327

Mailing address

14340 John Scagno
El Paso, TX 79938-3207
Phone (678) 637-7985

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1726012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770249600000",
    "number": "1124854534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14340 JOHN SCAGNO",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799383207",
            "telephone_number": "678-637-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18511 HIGHLANDER MEDICS ST",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799065327",
            "telephone_number": "915-742-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "TYLER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-11",
        "last_updated": "2026-02-05",
        "certification_date": "2026-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.