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LISA M BASHORE PNP
NPI 1750522397
Nurse Practitioner - Pediatrics in Fort Worth, TX

Active since March 11, 2009PECOS Enrolled
1500 COOPER ST, FORT WORTH, TX 76104(682) 885-4007(682) 885-4004 Get Directions Write a Review

NPPES record last updated: May 10, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 10, 2021, Apr 9, 2021 (2 updates tracked since 2021).

About Lisa M Bashore Pnp NPPES

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

LISA M BASHORE PNP (NPI 1750522397) is an individual pediatrics provider in Fort Worth, Texas, licensed in Texas (673778) and active in the NPI registry since March 2009. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750522397
Entity TypeIndividualFemale
Primary Taxonomy363LP0200X
Provider Legal NameLISA M BASHORECredential: PNP
Location Address1500 COOPER STFort Worth, TX 76104-2710
Mailing AddressPo Box 733784Dallas, TX 75373-3784 · (682) 885-1855 · Fax (682) 885-1396
Phone(682) 885-4007
Fax(682) 885-4004
Sole ProprietorNo
Enumeration DateMarch 11, 2009
Last NPPES UpdateMay 10, 20212 updates tracked since enumeration
NPPES CertifiedMay 10, 2021
✔ NPI 1750522397 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · PediatricsPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0200X
License✔ Licensed in TX · 673778
1500 COOPER ST, Fort Worth, TX 76104
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Imperial Insurance Companies, Inc..Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa M Bashore Pnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Lisa Bashore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cook Children's Physician Network
Same address
Developmental - Behavioral Pediatrics
1500 COOPER ST
Fort Worth, TX 76104
  • Reassigned Medicare billing, Texas enrollment
  • Medicare enrollment name: Cook Childrens Physician Network
  • 1,186 clinicians in this Medicare group
NPI 1548230923 (682) 303-9200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76104 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

KATRINA L WILLIE-MUSOMA MD
Pediatrics (Neurodevelopmental Disabilities)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 303-9300
SCHARLYN R HENDERSON LCSW
Social Worker (Clinical)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-1475
GREGORY BARKER
Pediatrics (Pediatric Cardiology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2140
DR. ELORA PATTANAIK CORBIN M.D.
Psychiatry & Neurology (Neurology with Special Qualifications in Child Neurology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
SHANE KELLEHER PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-7840
BENJAMIN CRAIG PA-C
Physician Assistant
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-2500
DR. SHAILENDRA DAS D.O.
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299
JAMES C CUNNINGHAM MD
Pediatrics (Pediatric Pulmonology)
1500 COOPER ST
FORT WORTH, TX 76104
Tarrant County (682) 885-6299

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Bashore's NPI number?

The NPI number for Lisa Bashore is 1750522397. It was assigned to this individual provider in the NPPES registry on March 11, 2009.

Where is Lisa Bashore located?

Lisa Bashore practices at 1500 Cooper St, Fort Worth, TX 76104. The listed phone number is (682) 885-4007.

What is Lisa Bashore's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.

Is Lisa Bashore enrolled in Medicare?

Yes. Lisa Bashore is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lisa Bashore's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Bashore reassigns Medicare benefits to Cook Children's Physician Network (Fort Worth, TX). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Bashore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Bashore accept?

Health plans from Imperial Insurance Companies, Inc. list Lisa Bashore as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Bashore was last updated on May 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.