Individual provider Active NPI

Candice Elizabeth Brem, M.D.

  • Dermatopathology (Pathology) Physician
  • Boston, MA
National Provider Identifier
1144631367
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X
License
273953 Issued in MA
Practice address
609 Albany Street
3Rd Floor
Boston, MA 02118-2515
Phone
(617) 638-5566
Fax
(617) 638-5575
NPI assigned
May 9, 2014
Last updated
Feb 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X 273953 MA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 273953 MA

Addresses

Primary practice location

609 Albany Street
3Rd Floor
Boston, MA 02118-2515

Mailing address

960 Massachusetts Avenue
FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
3133637MedicaidNH
110134950AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200626000689 MA Practitioner - Pathology 5294086815
I20251212000344 TX Practitioner - Pathology 5294086815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 S Freeport Pkwy
Coppell, TX 75019-4435

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
273953MAMDDermatopathology (Pathology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Inform Diagnostics, Inc. Anatomic Pathology & Clinical Pathology Current Accepting new patients
Metroplex Pathology Associates Anatomic Pathology & Clinical Pathology CurrentSince Oct 31, 2025 Accepting new patients
Skin Pathology Laboratory, Inc. PastSince Feb 23, 2025 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

1111 S Freeport Pkwy
Coppell, TX 75019
Phone (214) 277-8700

5016 US Highway 75
Denison, TX 75020
Phone (855) 222-9637

Interoperability endpoints

  • Direct secure messaging: cbrem108942@direct.bmc.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1144631367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVENUE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 ALBANY STREET",
            "address_2": "3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182515",
            "telephone_number": "617-638-5566",
            "fax_number": "617-638-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREM",
        "first_name": "CANDICE",
        "middle_name": "ELIZABETH",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-09",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "MA",
            "license": "273953",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "273953",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3133637",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110134950A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.