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DR. MARA AINSLEY TIETZEN MD
NPI 1831720903
Pediatrics - Sports Medicine in Boston, MA

Active since January 28, 2020
300 LONGWOOD AVE, BOSTON, MA 02115(857) 218-4924(617) 730-0683 Get Directions Write a Review

NPPES record last updated: July 9, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jul 9, 2021, Jan 28, 2020 (2 updates tracked since 2020).

About Dr. Mara Ainsley Tietzen Md NPPES

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

DR. MARA AINSLEY TIETZEN MD (NPI 1831720903) is an individual sports medicine provider in Boston, Massachusetts, licensed in Massachusetts (283657) and active in the NPI registry since January 2020.

NPPES Registry Identity

NPI1831720903
Entity TypeIndividualFemale
Primary Taxonomy2080S0010X
Provider Legal NameDR. MARA AINSLEY TIETZENCredential: MD
Location Address300 LONGWOOD AVEBoston, MA 02115-5724
Mailing Address300 Longwood AveBoston, MA 02115-5724 · (617) 355-6000 · Fax (617) 730-0683
Phone(857) 218-4924
Fax(617) 730-0683
Sole ProprietorYes
Enumeration DateJanuary 28, 2020
Last NPPES UpdateJuly 9, 20212 updates tracked since enumeration
NPPES CertifiedJuly 9, 2021
✔ NPI 1831720903 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatrics · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080S0010X
License✔ Licensed in MA · 283657
Definition

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.

Also ListedPediatricsTaxonomy 208000000X · License 41268 (ZZ)
300 LONGWOOD AVE, Boston, MA 02115
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JULIE ANN HANSEN LCSW
Social Worker (Clinical)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (857) 218-4309
MS. ANNA ROGLIERI
Nurse Practitioner (Psychiatric/Mental Health)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
STEPHEN G. FLYNN M.D.
Anesthesiology (Pediatric Anesthesiology)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000
MISS LAUREN ASHLEY MASTERSON P.T., D.P.T
Physical Therapist
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-7216
MS. SOYUN KWAN LICSW
Social Worker (Clinical)
300 LONGWOOD AVE, CHILDREN'S HOSPITAL BOSTON
BOSTON, MA 02115
Suffolk County (617) 355-0567
PUJA BANKA M.D.
Pediatrics
300 LONGWOOD AVE, BADER 203
BOSTON, MA 02115
Suffolk County (617) 355-6363
MR. COURTNEY SULLIVAN FRATTO CPNP
Nurse Practitioner (Pediatrics)
300 LONGWOOD AVE, HUNNEWELL BUILDING 322
BOSTON, MA 02115
Suffolk County (857) 218-4085
DR. ELIZABETH S TAGLAUER M.D., PH.D.
Pediatrics (Neonatal-Perinatal Medicine)
300 LONGWOOD AVE
BOSTON, MA 02115
Suffolk County (617) 355-6000

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 Mara Tietzen's NPI number?

The NPI number for Mara Tietzen is 1831720903. It was assigned to this individual provider in the NPPES registry on January 28, 2020.

Where is Mara Tietzen located?

Mara Tietzen practices at 300 Longwood Ave, Boston, MA 02115. The listed phone number is (857) 218-4924.

What is Mara Tietzen's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Sports Medicine, with taxonomy code 2080S0010X.

When was this NPI record last updated?

The NPPES record for Mara Tietzen was last updated on July 9, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.