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

Q: 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.

Q: What is Lisa Bashore's specialty?

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

Q: 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.

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: August 16, 2026.

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

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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

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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, and ordering and referring status from the CMS PECOS system.

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.

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)