Dirk Bradley Bahoravitch, MSN, CRNA
NPI 1184083826ActiveIndividual· Nurse Anesthetist, Certified Registered· Provo, UT
Nurse Anesthetist, Certified Registered (MSN, CRNA) with Main Street Anesthesia of New Mexico, LLC, practicing in Provo, Utah. Enrolled in Medicare as practitioner - certified registered nurse anesthetist (crna) and practitioner - certified registered nurse anesthetist (crna). Lists Lovelace Medical Center as a hospital affiliation.
Overview
| NPI | 1184083826 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MSN, CRNA |
| Sole proprietor | Yes |
| NPI issued | Feb 22, 2016 |
| Last updated in NPPES | Jan 19, 2021 |
| Certified by provider | Jan 19, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 53485 | ID |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (KY); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (MT); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (ND); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (NM); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (OR); Practitioner - Certified Registered Nurse Anesthetist (CRNA) (TX) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Main Street Anesthesia of New Mexico, LLCRio Rancho, NM · 236 clinicians
Hospital affiliation
- Lovelace Medical CenterAlbuquerque, NM
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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