NPIMap

Individual provider Active NPI

Tyler Lee Bloomer, M.D.

  • Interventional Cardiology Physician
  • Fort Worth, TX
National Provider Identifier
1306104765
Registry record updated Jun 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
R9719 Issued in TX
Practice address
1300 W Terrell Ave Ste 500
Fort Worth, TX 76104-2810
Phone
(817) 252-5000
Fax
(817) 252-5016
NPI assigned
Apr 23, 2012
Last updated
Jun 25, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 52345 TN
Cardiovascular Disease Physician 207RC0000X R9719 TX
Interventional Cardiology Physician 207RI0011X R9719 TX Primary

Addresses

Primary practice location

1300 W Terrell Ave Ste 500
Fort Worth, TX 76104-2810

Mailing address

1300 W Terrell Ave Ste 500
Fort Worth, TX 76104-2810
Phone (817) 252-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190910002857 TX Practitioner - Interventional CardiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 2769786722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
University of Texas Medical School at San Antonio, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

1300 W Terrell Ave
Suite 500
Fort Worth, TX 76104-2810
Phone (817) 252-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.64 of 100Reported as individual
Quality
88.12
Promoting interoperability
100
Improvement activities
40
Cost
77.35

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting38
Pacemaker insertion or repair1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R9719TXMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Physicians Group Current Accepting new patients
Texas Health Physicians Group CurrentSince Aug 1, 2019 Accepting new patients
Texas Health Physicians Group Internal Medicine CurrentSince Aug 1, 2019 Accepting new patients
Texas Health Physicians Group Internal Medicine Past Accepting new patients

Locations

1600 Hospital Pkwy
Bedford, TX 76022
Phone (817) 355-7803

4333 N Josey Ln
Ste 104
Carrollton, TX 75010
Phone (972) 394-4500

201 Walls Dr
Cleburne, TX 76033
Phone (817) 556-5587

6100 Harris Pkwy
Ste 1200
Fort Worth, TX 76132
Phone (817) 263-3724

1300 W Terrell Ave
Ste 500
Ft Worth, TX 76104
Phone (817) 252-5000

Interoperability endpoints

  • Direct secure messaging: tbloomer1514473@direct.texashealth.org

Organizations & group practices 4

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 5

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": "1335139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561420800000",
    "number": "1306104765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042810",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W TERRELL AVE STE 500",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042810",
            "telephone_number": "817-252-5000",
            "fax_number": "817-252-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLOOMER",
        "first_name": "TYLER",
        "middle_name": "LEE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-23",
        "last_updated": "2019-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "52345",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "R9719",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "R9719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.