SUCCOR PRIMARY CARE, P.C
NPI 1295311207
Nurse Practitioner - Primary Care in Waltham, MA

Q: What is Succor Primary Care Inc's NPI number?

The NPI number for Succor Primary Care Inc is 1295311207. It was assigned to this organization in the NPPES registry on March 20, 2021. The provider is also known as Succor Primary Care, P.C.

Q: What is Succor Primary Care Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Active since March 20, 2021CLIA 22D2278143 · Waiver

24 CRESCENT ST STE 407, WALTHAM, MA 02453(781) 358-8633(781) 205-7602 Get Directions Write a Review

NPPES record last updated: March 16, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 27, 2022, Mar 23, 2021, Mar 20, 2021 (3 updates tracked since 2021).

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About Succor Primary Care, P.c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUCCOR PRIMARY CARE, P.C (NPI 1295311207) is a healthcare organization registered as a primary care in Waltham, Massachusetts and active in the NPI registry since March 2021. The organization holds a CLIA Waiver certificate valid through March 12, 2027 and lists Lelia Janice Magoba, President, as its authorized official.

NPPES Registry Identity

NPI1295311207

Entity TypeOrganization

Primary Taxonomy363LP2300X

Legal Business NameSUCCOR PRIMARY CARE INC

Location Address24 CRESCENT ST STE 407Waltham, MA 02453-4309

Mailing Address24 Crescent St Ste 407Waltham, MA 02453-4309 · (781) 358-8633 · Fax (781) 205-7602

Phone(781) 358-8633

Fax(781) 205-7602

Organization SubpartNo

Authorized OfficialLelia Janice MagobaPresident · (781) 358-8633

Enumeration DateMarch 20, 2021

Last NPPES UpdateMarch 16, 20223 updates tracked since enumeration

NPPES CertifiedFebruary 8, 2022

✔ NPI 1295311207 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

24 CRESCENT ST STE 407, Waltham, MA 02453

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Other Names 1

Other NameSuccor Primary Care, P.c

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2278143

Succor Primary Care, Inc · Waltham, MA

Active · expires Mar 12, 2027

CLIA Number22D2278143

Laboratory TypePractitioner Other

Certificate Effective DateMarch 13, 2025

Certificate Expiration DateMarch 12, 2027

Laboratory DirectorLelia Magoba

Laboratory Phone(781) 358-8633

Laboratory LocationSuccor Primary Care, Inc24 Crescent St Ste 304, Waltham, MA 02453

CLIA data matches this NPI record on: Name Phone

This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Succor Primary Care Inc's NPI number?

The NPI number for Succor Primary Care Inc is 1295311207. It was assigned to this organization in the NPPES registry on March 20, 2021. The provider is also known as Succor Primary Care, P.C.

Where is Succor Primary Care Inc located?

Succor Primary Care Inc is located at 24 Crescent St Ste 407, Waltham, MA 02453. The listed phone number is (781) 358-8633.

What is Succor Primary Care Inc's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Does Succor Primary Care Inc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2278143) is associated with this NPI, valid through March 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Succor Primary Care Inc was last updated on March 16, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.