Active NPI
Lisa A Thayer, M.D.
- Pediatrics Physician
- Watertown, MA
National Provider Identifier
1073593299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 155172
- Practice address
- 485 Arsenal St
Watertown, MA 02472-5091 - Phone
- (617) 972-5570
- Fax
- (617) 972-5593
- NPI assigned
- Jan 23, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 155172 | MA | Primary |
Addresses
Primary practice location
485 Arsenal St
Watertown, MA 02472-5091
Mailing address
485 Arsenal St
Watertown, MA 02472-5091
Phone (617) 972-5570
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0015185 | Other | MA | NEIGHBORHOOD HEALTH |
| 3189732 | Medicaid | MA | |
| J19137 | Other | MA | BLUE CROSS |
| PP820 | Other | MA | HARVARD PILGRIM |
| 155172 | Other | MA | TUFTS |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lthayermd7201@direct.atrius.masshiway.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1615161600000",
"number": "1073593299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "485 ARSENAL ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024725091",
"telephone_number": "617-972-5570",
"fax_number": "617-972-5593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "485 ARSENAL ST",
"city": "WATERTOWN",
"state": "MA",
"postal_code": "024725091",
"telephone_number": "617-972-5570",
"fax_number": "617-972-5593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THAYER",
"first_name": "LISA",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-23",
"last_updated": "2021-03-08",
"certification_date": "2021-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "155172",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0015185",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3189732",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J19137",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "PP820",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "155172",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lthayermd7201@direct.atrius.masshiway.net",
"affiliation": "N",
"address_1": "485 Arsenal St",
"city": "Watertown",
"state": "MA",
"country_code": "US",
"postal_code": "024725091",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Watertown, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.