Elise W Ballou, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

5902 Issued in AZ

Practice address

275 E Rivulon Blvd Ste 201
Gilbert, AZ 85297-0008

Phone

(602) 734-5664

Fax

(480) 401-3844

NPI assigned

Dec 1, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Paramount Behavioral Health Services PLLC

  • Psychiatry Physician
  • Phoenix, AZ
  • NPI 1366941361

  AZ

  Medicare reassignment Authorized official
• Alsham Medical PLLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1780815712
  NPD (past)
• Integrated Premier Group Ipg

  • Hospitalist Physician
  • Phoenix, AZ
  • NPI 1497176788
  NPD (past)
• Kidney Guardian

  • Nephrology Physician
  • Tempe, AZ
  • NPI 1013475326
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523318400000",
    "number": "1720485147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 E RIVULON BLVD STE 201",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970008",
            "telephone_number": "602-734-5664",
            "fax_number": "480-401-3844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 E RIVULON BLVD STE 201",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852970008",
            "telephone_number": "602-734-5664",
            "fax_number": "480-401-3844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLOU",
        "first_name": "ELISE",
        "middle_name": "W",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-01",
        "last_updated": "2018-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison Ball
• Bradford Ball, D.D.S.
• Jessie Ball, FNP
• Tayler Ball, MS, OTR/L
• Andrew Ballard
• Alyssia Desiree Banda, RN
• Brian Robert Banfield, DMD
• Hannah Bangura, ACNP-BC
• Banner Canyon Springs Surgery Center LP
• Banner Gateway Medical Center

• All providers in Gilbert, AZ
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.