Dirk Bradley Bahoravitch, MSN, CRNA - Medicare Nurse Anesthetist, Certified Registered in Provo, UT

Dirk Bradley Bahoravitch, MSN, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Provo, Utah. His current practice location is 1067 N 500 W, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 374-0354.

Dirk Bradley Bahoravitch is licensed to practice in Idaho (license number 53485) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184083826.

Contact Information

Dirk Bradley Bahoravitch, MSN, CRNA
1067 N 500 W,
Provo, UT 84604-3305
(801) 374-0354
Not Available

Map and Direction




Provider's Profile

Full NameDirk Bradley Bahoravitch
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location1067 N 500 W, Provo, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1184083826
  • Provider Enumeration Date: 02/22/2016
  • Last Update Date: 01/19/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 0941595441
  • Enrollment ID: I20190917003288

Medical Identifiers

Medical identifiers for Dirk Bradley Bahoravitch such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1184083826NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered 53485 (Idaho)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dirk Bradley Bahoravitch allows following entities to bill medicare on his behalf.
Entity NameRadius Anesthesia Of New Mexico Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376092403
PECOS PAC ID: 1153672159
Enrollment ID: O20181001000769
Entity NameMain Street Anesthesia Of New Mexico, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275010985
PECOS PAC ID: 3476807538
Enrollment ID: O20181108002622

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dirk Bradley Bahoravitch is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dirk Bradley Bahoravitch, MSN, CRNA
264 N 1020 E,
American Fork, UT 84003-2957

Ph: (801) 592-5424
Dirk Bradley Bahoravitch, MSN, CRNA
1067 N 500 W,
Provo, UT 84604-3305

Ph: (801) 374-0354

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Provo, UT

Sarah Ward Barnaby, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1034 N 500 W, Provo, UT 84604
Phone: 801-727-2056    Fax: 770-701-6675
Rodney L Fisher, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 320 River Park Dr Ste 125, Provo, UT 84604
Phone: 801-375-8049    Fax: 801-374-9195
Chase Bazil, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 1900 N State St Ste 105, Provo, UT 84604
Phone: 801-655-5245    
Shelby Lyn Beck,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1067 N 500 W, Provo, UT 84604
Phone: 801-374-0354    
Joyce Westphal, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 585 N 500 W, Provo, UT 84601
Phone: 801-375-0983    Fax: 801-375-0988
Samantha Anderson,
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 1034 N 500 W, Provo, UT 84604
Phone: 608-695-0168    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.