Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dirk Bradley Bahoravitch, MSN, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1184083826

Dirk Bradley Bahoravitch, MSN, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Provo, Utah. Qualified in 2016, 10 years ago. Practices with Main Street Anesthesia of New Mexico, LLC, a 228-clinician group and accepts Medicare assignment. Licensed in Idaho.

Years since qualifying
10
Licensed in
ID
In the registry since
2016
What do these letters mean?
MSN — Master of Science in Nursing
A graduate nursing degree, usually held alongside an advanced practice licence.
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

1067 N 500 W
Provo, UT 84604-3305
Phone: (801) 374-0354
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 53485 (ID)

Record details

NPI number1184083826
Entity typeIndividual (Type 1)
GenderMale
Credentials MSN , CRNA
Sole proprietorYes
NPI enumeratedFebruary 22, 2016
Last updated in NPPESJanuary 19, 2021
Certification dateJanuary 19, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Main Street Anesthesia Of New Mexico, Llc — 228 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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