Organization Active NPI

Greater Boston Family Medicine PLLC

  • Family Medicine Physician
  • Needham, MA
National Provider Identifier
1114711900
Registry record updated Jun 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GREATER BOSTON FAMILY MEDICINE PLLC
Practice address
35 Highland Cir Ste 306
Needham, MA 02494-3099
Phone
(781) 973-0052
NPI assigned
Apr 7, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2026

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

Authorized official

Name
Luisa Mazaeva, FNPNPI 1235984410
Title
Owner
Phone
(781) 973-0052

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

35 Highland Cir Ste 306
Needham, MA 02494-3099

Mailing address

35 Highland Cir Ste 306
Needham, MA 02494-3099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250912004010 MA Part B Supplier - Clinic/Group Practice 9638672793 Receives reassigned benefits from 2 practitioners
Practice locations: Needham, MA

National Provider Directory

National Provider Directory

Locations

35 Highland Cir
Ste 306
Needham, MA 02494

35 Highland Cir
Ste 101
Needham Heights, MA 02494
Phone (781) 973-0052

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1114711900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HIGHLAND CIR STE 306",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HIGHLAND CIR STE 306",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024943099",
            "telephone_number": "781-973-0052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER BOSTON FAMILY MEDICINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-07",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "MAZAEVA",
        "authorized_official_first_name": "LUISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-973-0052",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Needham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.