Mara Tietzen, MD
Mara Tietzen, MD is a Pediatric Sports Medicine Physician in Boston, MA, registered under NPI 1831720903. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 300 LONGWOOD AVE, Boston, MA 02115. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 283657 | MA | Pediatric Sports Medicine Physician primary |
| 41268 | ZZ | Pediatrics Physician |
Licences are recorded in 2 states: MA, ZZ. Providers licensed in several states often practise near a state border or deliver telehealth across state lines.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Sports Medicine covers
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. NUCC Health Care Provider Taxonomy, code 2080S0010X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 2080S0010X | Pediatric Sports Medicine Physician Sports Medicine | 283657 | MA | primary |
| 208000000X | Pediatrics Physician | 41268 | ZZ |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1831720903 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Jan 28, 2020 |
| Last updated | Jul 9, 2021 |
| Status | Active |
| Sole proprietor | Yes |
| Credential | MD |
| Practice address |
300 LONGWOOD AVE Boston, MA 02115 (857) 218-4924 Fax (617) 730-0683 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 8 | 3 | 1 | 7 | 2 | 0 | 9 | 0 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 8 | 6 | 1 | 5 | 2 | 0 | 9 | 0 |
Sum = 57 · next multiple of 10 = 60 · check digit = 3 · actual last digit = 3
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.