Mr Kordale Tre Bavor, NP - Medicare Nurse Practitioner in Bonney Lake, WA

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Mr Kordale Tre Bavor, NP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Bonney Lake, Washington. His current practice location is 10004 204th Ave E Ste 1300, Bonney Lake, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 848-8797.

Mr Kordale Tre Bavor is licensed to practice in Washington (license number 61422757) 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 1659984631.

Contact Information

Mr Kordale Tre Bavor, NP
10004 204th Ave E Ste 1300,
Bonney Lake, WA 98391-6537
(253) 848-8797
Not Available

Map and Direction




Provider's Profile

Full NameMr Kordale Tre Bavor
GenderMale
SpecialityNurse Practitioner - Pediatrics
Location10004 204th Ave E Ste 1300, Bonney Lake, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1659984631
  • Provider Enumeration Date: 08/28/2020
  • Last Update Date: 08/22/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 8820452055
  • Enrollment ID: I20230906003875

Medical Identifiers

Medical identifiers for Mr Kordale Tre Bavor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1659984631NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 61422757 (Washington)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. Mr Kordale Tre Bavor allows following entities to bill medicare on his behalf.
Entity NameMulticare Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497766638
PECOS PAC ID: 7719899897
Enrollment ID: O20031105000760

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. Mr Kordale Tre Bavor 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
Mr Kordale Tre Bavor, NP
10004 204th Ave E Ste 1300,
Bonney Lake, WA 98391-6537

Ph: (253) 848-8797		Mr Kordale Tre Bavor, NP
10004 204th Ave E Ste 1300,
Bonney Lake, WA 98391-6537

Ph: (253) 848-8797

Reviews and Comments


Nurse Practitioner Nurses in Bonney Lake, WA

Rachel Lee Criddle, MSN, NP-C, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9230 Sky Island Dr E, Bonney Lake, WA 98391
Phone: 253-750-6000    Fax: 253-750-6100
Kiersti Devaney, ARNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 10004 204th Ave E, Bonney Lake, WA 98391
Phone: 253-848-5951    Fax: 253-845-7073
Megan Barker,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 9230 Sky Island Dr E, Bonney Lake, WA 98391
Phone: 253-750-6000    
Mr. Timothy Fletcher-velasco, FNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 19647 Wa-410, Bonney Lake, WA 98391
Phone: 253-921-4569    Fax: 253-750-3475
Michelle Christine Jackson, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9550 195th Ave E, Bonney Lake, WA 98391
Phone: 253-447-3400    
Maria Beloit, ARNP, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 9230 Sky Island Dr E Fl 2, Bonney Lake, WA 98391
Phone: 253-750-6000    
Mrs. Teresa Ann Marshall, ARNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 10004 204th Ave E, #3400, Bonney Lake, WA 98391
Phone: 253-848-5951    Fax: 253-845-7073

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.