DIRK BRADLEY BAHORAVITCH MSN, CRNA
NPI 1184083826
Nurse Anesthetist, Certified Registered in Provo, UT
About Dirk Bradley Bahoravitch Msn, Crna NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DIRK BRADLEY BAHORAVITCH MSN, CRNA (NPI 1184083826) is an individual nurse anesthetist, certified registered in Provo, Utah, licensed in Idaho (53485) and active in the NPI registry since February 2016. He is enrolled in Medicare PECOS, is affiliated with Lovelace Medical Center, and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dirk Bradley Bahoravitch Msn, Crna is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
9Medicare enrollment records show Dirk Bahoravitch reassigns Medicare billing to 9 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Albuquerque, NM 87109
- Reassigned Medicare billing, New Mexico enrollment
- 29 clinicians in this Medicare group
Albuquerque, NM 87102
- Reassigned Medicare billing, New Mexico enrollment
- 383 clinicians in this Medicare group
Pine Ridge, SD 57770
- Reassigned Medicare billing, Texas enrollment
- 426 clinicians in this Medicare group
Sidney, MT 59270
- Reassigned Medicare billing, Montana enrollment
- Also billed through NPI 1285719161 (Montana)
- 149 clinicians in this Medicare group
Portland, OR 97213
- Reassigned Medicare billing, Oregon enrollment
- 419 clinicians in this Medicare group
Williston, ND 58801
- Reassigned Medicare billing, North Dakota enrollment
- 268 clinicians in this Medicare group
Monahans, TX 79756
- Reassigned Medicare billing, Texas enrollment
- Also billed through NPI 1720096019 (Texas)
- 56 clinicians in this Medicare group
Fort Worth, TX 76109
- Reassigned Medicare billing, Texas enrollment
- 1,612 clinicians in this Medicare group
Lexington, KY 40509
- Reassigned Medicare billing, Kentucky enrollment
- 462 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Lovelace Medical Center
Acute Care Hospitals · Albuquerque, NMPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84604 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 9
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dirk Bahoravitch's NPI number?
The NPI number for Dirk Bahoravitch is 1184083826. It was assigned to this individual provider in the NPPES registry on February 22, 2016.
Where is Dirk Bahoravitch located?
Dirk Bahoravitch practices at 1067 N 500 W, Provo, UT 84604. The listed phone number is (801) 374-0354.
What is Dirk Bahoravitch's specialty?
The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.
Is Dirk Bahoravitch enrolled in Medicare?
Yes. Dirk Bahoravitch is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dirk Bahoravitch's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dirk Bahoravitch reassigns Medicare benefits to 9 organizations: Radius Anesthesia Of New Mexico LLC (Albuquerque, NM), Main Street Anesthesia Of New Mexico, LLC (Albuquerque, NM), Pine Ridge Indian Health Service Hospital (Pine Ridge, SD), Sidney Health Center (Sidney, MT), Hospitalist Medicine Physicians Of Washington - Tcs (Portland, OR) and 4 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dirk Bahoravitch's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dirk Bahoravitch accept?
Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas and Mountain Health CO-OP list Dirk Bahoravitch as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Dirk Bahoravitch affiliated with any hospitals?
According to CMS data, Dirk Bahoravitch is affiliated with Lovelace Medical Center.
When was this NPI record last updated?
The NPPES record for Dirk Bahoravitch was last updated on January 19, 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.
# Dirk Bradley Bahoravitch, MSN, CRNA · NPI 1184083826
Nurse Anesthetist, Certified Registered physician in Provo, Utah. Individual provider, active in the CMS NPPES registry since February 22, 2016.
## Identity
- **NPI:** 1184083826 (Entity type: Individual)
- **Enumerated:** February 22, 2016
- **Primary specialty:** Nurse Anesthetist, Certified Registered · taxonomy 367500000X
- **State license:** 53485 (Idaho)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1067 N 500 W, Provo, UT 84604-3305
- **Phone:** (801) 374-0354
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging
- **Bills Medicare through:** 9 organizations under Medicare reassignment (form CMS-855R): Radius Anesthesia Of New Mexico LLC (NPI 1376092403, Albuquerque, NM); Main Street Anesthesia Of New Mexico, LLC (NPI 1275010985, Albuquerque, NM); Pine Ridge Indian Health Service Hospital (NPI 1497786412, Pine Ridge, SD); Sidney Health Center (NPI 1568532802, Sidney, MT); Hospitalist Medicine Physicians Of Washington - Tcs (NPI 1649816380, Portland, OR); and 4 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** January 19, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1184083826) · Data from the CMS NPPES public registry.