Individual provider

Dylan Clark, STUDENT

Certified Registered Nurse Anesthetist Registered Nurse Medicare enrolled

Dylan Clark, STUDENT is a Certified Registered Nurse Anesthetist in Boston, MA, registered under NPI 1104530930. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.

Getting there

The practice address on file is 1 BOSTON MEDICAL CENTER PLACE, Boston, MA 02118. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

1 BOSTON MEDICAL CENTER PLACE, Boston, MA 02118 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
RN2287470 MA Certified Registered Nurse Anesthetist primary
RN2287470 MA Registered Nurse

This provider holds licence RN2287470 issued in MA. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Certified Registered Nurse Anesthetist (crna)
PAC ID
7810409661

Medicare enrolment is recorded as approved under the provider type Practitioner - Certified Registered Nurse Anesthetist (crna). This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Nurse Anesthetist, Certified Registered covers

(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition. NUCC Health Care Provider Taxonomy, code 367500000X
Physician Assistants & Advanced Practice Nursing Providers Nurse Anesthetist, Certified Registered

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
367500000X Certified Registered Nurse Anesthetist RN2287470 MA primary
163W00000X Registered Nurse RN2287470 MA

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1104530930 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateJan 6, 2023
Last updatedApr 2, 2026
StatusActive
Sole proprietorYes
CredentialSTUDENT
Practice address 1 BOSTON MEDICAL CENTER PLACE
Boston, MA 02118
(617) 638-6950
Mailing address 960 MASSACHUSETTS AVE FLR 2
Boston, MA 02118
Other identifiers 110224269A (MA)
3150309 (NH)
This record was updated on Apr 2, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1104530930 passes the NPI check digit test The final digit 0 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 1 0 4 5 3 0 9 3
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 1 0 4 1 3 0 9 6

Sum = 50 · next multiple of 10 = 50 · check digit = 0 · actual last digit = 0

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1104530930?
NPI 1104530930 is the National Provider Identifier assigned to Dylan Clark, STUDENT in Boston, MA. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Certified Registered Nurse Anesthetist cover?
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care…
How do I contact Dylan Clark, STUDENT?
The phone number on file with NPPES is (617) 638-6950, last updated Apr 2, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Dylan Clark, STUDENT accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1104530930 a valid number?
Yes. 1104530930 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.