Individual provider Active NPI

Elisa Basora Rovira, MD

  • Pediatric Pulmonology Physician
  • Dallas, TX
National Provider Identifier
1396979639
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Pulmonology PhysicianTaxonomy code 2080P0214X
License
R1703 Issued in TX
Practice address
2350 N. Stemmons Fwy (I-35)
Dallas Ambulatory Care Pavillion
Dallas, TX 75207
Phone
(214) 456-4630
Fax
(214) 456-5406
NPI assigned
May 13, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X R1703 TX
Pediatric Sleep Medicine Physician 2080S0012X R1703 TX
General Practice Physician 208D00000X 017516 PR
Pediatric Pulmonology Physician 2080P0214X R1703 TX Primary

Addresses

Primary practice location

2350 N. Stemmons Fwy (I-35)
Dallas Ambulatory Care Pavillion
Dallas, TX 75207

Mailing address

2140 Medical District Dr Apt 4069
Dallas, TX 75235-8286
Phone (787) 457-0657

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200409002807 TX Practitioner - Pediatric MedicinePractitioner - Pulmonary Disease 7012346216 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R1703TXMDPediatric Pulmonology Physician
017516PRMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Elisa Basora Rovira MD PLLC Pediatric Pulmonology Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatric Pulmonology Current Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 5, 2020 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Pediatrics CurrentSince Jan 5, 2020 Accepting new patients
Children'S Health System of Texas Past Accepting new patients

Locations

2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000

2350 N Stemmons Fwy
#I35
Dallas, TX 75207
Phone (214) 456-4630

2817 S Mayhill Rd
Ste 115
Denton, TX 76208
Phone (972) 634-2931

1651 Justin Rd
Flower Mound, TX 75028
Phone (972) 691-9800

420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618

7601 Preston Rd
Plano, TX 75024
Phone (469) 303-7300

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

Organizations & group practices 5

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": "1242172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1396979639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2140 MEDICAL DISTRICT DR APT 4069",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752358286",
            "telephone_number": "787-457-0657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N. STEMMONS FWY (I-35)",
            "address_2": "DALLAS AMBULATORY CARE PAVILLION",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75207",
            "telephone_number": "214-456-4630",
            "fax_number": "214-456-5406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BASORA ROVIRA",
        "first_name": "ELISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-05-13",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "R1703",
            "primary": false
        },
        {
            "code": "2080S0012X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Sleep Medicine",
            "state": "TX",
            "license": "R1703",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "017516",
            "primary": false
        },
        {
            "code": "2080P0214X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Pulmonology",
            "state": "TX",
            "license": "R1703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.