Kavita Davenport, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Tustin, California. Her current practice location is
230 Jet Strm, Tustin, California. You can reach out to her office (for appointments etc.) via phone at
(213) 675-1048.
Kavita Davenport is licensed to practice in California (license number 95000367) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1730558545.
Provider's Profile
| Full Name | Kavita Davenport |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 230 Jet Strm, Tustin, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1730558545
- Provider Enumeration Date: 09/22/2015
- Last Update Date: 09/22/2015
Medicare PECOS Information:
- PECOS PAC ID: 5991057408
- Enrollment ID: I20181011001150
Medical Identifiers
Medical identifiers for Kavita Davenport such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1730558545 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 95000367 (California) | 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. Kavita Davenport allows following entities to bill medicare on her behalf.
| Entity Name | Raelle Anesthesia Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437499266
PECOS PAC ID: 8123260874
Enrollment ID: O20130809000303 |
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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. Kavita Davenport 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 Address | Practice Location Address |
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Kavita Davenport, CRNA
230 Jet Strm,
Tustin, CA 92782-6525
Ph: (213) 675-1048 | Kavita Davenport, CRNA
230 Jet Strm,
Tustin, CA 92782-6525
Ph: (213) 675-1048 |
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