Individual provider Active NPI

Michael Shawn Nye, PA

  • Physician Assistant
  • Boerne, TX
National Provider Identifier
1427252352
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05304 Issued in TX
Practice address
37131 Interstate 10 W BLDG 400
Boerne, TX 78006-8989
Phone
(830) 307-5758
Fax
(830) 214-8649
NPI assigned
Jun 13, 2007
Last updated
Jul 16, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 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 PA05304 TX Primary

Addresses

Primary practice location

37131 Interstate 10 W BLDG 400
Boerne, TX 78006-8989

Mailing address

37131 Interstate 10 W BLDG 400
Boerne, TX 78006-8989
Phone (830) 307-5758

Other practice location 1

212 US Highway 87 Unit A
Comfort, TX 78013-3738
Phone (830) 307-5758

Other identifiers 4

IdentifierTypeStateIssuer
1417372624OtherTXGROUP NPI
880N98OtherTXBCBS
354618ZG9WOtherTXPTAN
206513802MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Carpenter's Touch Chiropractic Wellness Center, P.a. PastSince Jul 22, 2025 Accepting new patients
Orthorehab LLC PastSince Oct 12, 2019 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1427252352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37131 INTERSTATE 10 W BLDG 400",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068989",
            "telephone_number": "830-307-5758",
            "fax_number": "830-214-8649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37131 INTERSTATE 10 W BLDG 400",
            "city": "BOERNE",
            "state": "TX",
            "postal_code": "780068989",
            "telephone_number": "830-307-5758",
            "fax_number": "830-214-8649"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "212 US Highway 87 Unit A",
            "address_purpose": "LOCATION",
            "city": "Comfort",
            "state": "TX",
            "postal_code": "780133738",
            "country_code": "US",
            "telephone_number": "830-307-5758",
            "fax_number": "830-214-8649",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NYE",
        "first_name": "MICHAEL",
        "middle_name": "SHAWN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-13",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05304",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1417372624",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "880N98",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "354618ZG9W",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206513802",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boerne, TX

Sources for this page

Verify at the official NPI Registry.