Elise Victoria Balasa, MSN, CPNP-PC

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

1169378 Issued in TX

Practice address

801 7TH Ave
Fort Worth, TX 76104-2733

Phone

(682) 885-4095

Fax

(682) 885-7499

NPI assigned

Jul 23, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ebalasa227560@cookchildrens.direct-ci.com

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.

• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1750369203
  Medicare reassignment NPD
• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• Cook Children's Physician Network

  • Pediatrics Physician
  • Fort Worth, TX
  • NPI 1083472062
  NPD
• Cook Children's Medical Center

  dba Cook Children's Behavioral Health

  • Clinical Child & Adolescent Psychologist
  • Fort Worth, TX
  • NPI 1942509963
  NPD (past)
• Texas Children's Hospital

  dba Texas Children's Hospital North Austin Campus

  • Children's Hospital
  • Austin, TX
  • NPI 1194507947
  NPD (past)

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

{
    "created_epoch": "1721692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749600000000",
    "number": "1902634702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 733784",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753733784",
            "telephone_number": "682-885-6483",
            "fax_number": "682-885-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 7TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761042733",
            "telephone_number": "682-885-4095",
            "fax_number": "682-885-7499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALASA",
        "first_name": "ELISE",
        "middle_name": "VICTORIA",
        "credential": "MSN, CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-23",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1169378",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "1169378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ebalasa227560@CookChildrens.direct-ci.com",
            "affiliation": "N",
            "address_1": "801 7th Ave",
            "city": "Fort Worth",
            "state": "TX",
            "country_code": "US",
            "postal_code": "761042733",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stephen Edward Baker, M.D.
• Teresa Diane Baker, RN
• Anjuli Bala
• Saravanan Balamuthusamy, M.D.
• Alfred Balasa, M.D.
• Balch Interventional Pain and Wellness Center PLLC
• Cayli Nguyen Balch, D.O.
• Robert Judson Balch III, D.O.
• Susan Alice Baldelomar, L.P.C.
• Jasmine Balderas

• Primary Care Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Primary Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; 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.