Active NPI
Ivan Cancarevic, M.D.
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1215501234
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 1028393
- Practice address
- 75 Francis Street
Boston, MA 02115 - Phone
- (617) 732-5802
- NPI assigned
- May 14, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 1028393 | MA | |
| Internal Medicine Physician | 207R00000X | 1028393 | MA | Primary |
Addresses
Primary practice location
75 Francis Street
Boston, MA 02115
Mailing address
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5802
Other practice location 1
165 Cambridge St
Boston, MA 02114-2783
Phone (617) 726-5050
Other practice location 2
55 Fruit St
Boston, MA 02114-2621
Phone (617) 724-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260619002179 | MA | Practitioner - Nephrology | 4082187190 |
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Other, 2017
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
399 Revolution Dr
Suite 458
Somerville, MA 02145-1444
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3015633 | MA | MD | Nephrology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620950400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786492800000",
"number": "1215501234",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 FRANCIS ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156110",
"telephone_number": "617-732-5802"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 FRANCIS STREET",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-732-5802"
}
],
"practiceLocations": [
{
"address_1": "165 Cambridge St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021142783",
"country_code": "US",
"telephone_number": "617-726-5050",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "55 Fruit St",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021142621",
"country_code": "US",
"telephone_number": "617-724-4100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CANCAREVIC",
"first_name": "IVAN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-05-14",
"last_updated": "2026-08-12",
"certification_date": "2026-08-12",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "MA",
"license": "1028393",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "1028393",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.