Individual provider Active NPI

Ty Comer, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1831805209
Registry record updated May 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA16586 Issued in TX
Practice address
1106 Clayton LN Ste 102W
Austin, TX 78723-2433
Phone
(512) 872-6868
Fax
(877) 370-4267
NPI assigned
Jan 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA16586 TX
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X PA16586 TX Primary

Addresses

Primary practice location

1106 Clayton LN Ste 102W
Austin, TX 78723-2433

Mailing address

1106 Clayton LN Ste 102W
Austin, TX 78723-2433
Phone (512) 872-6868

Other practice location 1

2701 S Highway 183 Ste B
Leander, TX 78641-2366
Phone (512) 872-6868

Other practice location 2

1500 W 38th St Ste 20
Austin, TX 78731-6317
Phone (512) 872-6868

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240904000664 TX Practitioner - Physician Assistant 4385184472 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA16586TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mohamed S Ahmed MD PA PastSince Jan 1, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1674777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747699200000",
    "number": "1831805209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1106 CLAYTON LN STE 102W",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232433",
            "telephone_number": "512-872-6868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1106 CLAYTON LN STE 102W",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787232433",
            "telephone_number": "512-872-6868",
            "fax_number": "877-370-4267"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2701 S Highway 183 Ste B",
            "address_purpose": "LOCATION",
            "city": "Leander",
            "state": "TX",
            "postal_code": "786412366",
            "country_code": "US",
            "telephone_number": "512-872-6868",
            "fax_number": "877-370-4267",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 W 38th St Ste 20",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787316317",
            "country_code": "US",
            "telephone_number": "512-872-6868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMER",
        "first_name": "TY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-27",
        "last_updated": "2025-05-20",
        "certification_date": "2025-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA16586",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.