Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TYLER RAY HEIMDAL MD
NPI 1104447143
Orthopaedic Surgery - Orthopaedic Surgery of the Spine in Fort Worth, TX

Q: What is Tyler Heimdal's NPI number?

The NPI number for Tyler Heimdal is 1104447143. It was assigned to this individual provider in the NPPES registry on April 30, 2020.

Q: What is Tyler Heimdal's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Orthopaedic Surgery of the Spine, with taxonomy code 207XS0117X.

Q: When was this NPI record last updated?

The NPPES record for Tyler Heimdal was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 30, 2020PECOS Enrolled

1651 W ROSEDALE ST STE 200, FORT WORTH, TX 76104(817) 335-4316 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Aug 24, 2026, Aug 20, 2026 (2 updates tracked since 2026).

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About Tyler Ray Heimdal Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TYLER RAY HEIMDAL MD (NPI 1104447143) is an individual orthopaedic surgery of the spine provider in Fort Worth, Texas, licensed in Texas (W3270) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1104447143

Entity TypeIndividualMale

Primary Taxonomy207XS0117X

Provider Legal NameTYLER RAY HEIMDALCredential: MD

Location Address1651 W ROSEDALE ST STE 200Fort Worth, TX 76104-7437

Mailing AddressPo Box 961205Fort Worth, TX 76161-0205 · (817) 335-4316

Phone(817) 335-4316

Sole ProprietorNo

Enumeration DateApril 30, 2020

Last NPPES UpdateAugust 24, 20262 updates tracked since enumeration

NPPES CertifiedAugust 24, 2026

✔ NPI 1104447143 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic Surgery · Orthopaedic Surgery of the SpineAllopathic & Osteopathic Physicians

Taxonomy Code207XS0117X

License✔ Licensed in TX · W3270

Definition

Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive.

1651 W ROSEDALE ST STE 200, Fort Worth, TX 76104

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tyler Ray Heimdal Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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