NPIMap

Individual provider Active NPI

Lidya H Wlasiuk, M.D.

  • Family Medicine Physician
  • Boston, MA
National Provider Identifier
1003175910
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207999 Issued in CA
Practice address
850 Harrison Ave
Yacc 5
Boston, MA 02118-4001
Phone
(617) 414-2080
Fax
(617) 414-2090
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 207999 CA Primary
Family Medicine Physician 207Q00000X 264803 MA

Addresses

Primary practice location

850 Harrison Ave
Yacc 5
Boston, MA 02118-4001

Mailing address

720 Harrison Ave
Dob 503
Boston, MA 02118-2371

Other identifiers 1

IdentifierTypeStateIssuer
110102696AMedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151118000900 MA Practitioner - Family Practice 7214169556 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of California, Davis School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chapa-de Indian Health Program, Inc.Group PAC ID 4981688520, shared by 2 NPIs, 54 clinicians
South Boston Community Health CenterGroup PAC ID 2062487291, 57 clinicians

Practice addresses (Care Compare)

11670 Atwood Rd
Auburn, CA 95603-9522
Phone (530) 887-2800

409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207999CAMDFamily Medicine Physician
264803MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Obstetrics and Gynecology Foundation, Inc. CurrentSince Oct 15, 2015 Accepting new patients
Boston University Family Medicine, Inc. Family Medicine CurrentSince Oct 15, 2015 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
South Boston Community Health Center CurrentSince Oct 15, 2015 Accepting new patients

Locations

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
#5
Boston, MA 02118
Phone (617) 414-2000

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: lwlasiuk161058@direct.ochin.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/AHHIAD/Endpoint/AHHIAD
  • Direct secure messaging: lwlasiuk9184@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 and National Provider Directory roles.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1003175910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE",
            "address_2": "DOB 503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2080",
            "fax_number": "617-414-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WLASIUK",
        "first_name": "LIDYA",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-11",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "207999",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "264803",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110102696A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.