Active NPI
Taylor Thiesen, DO
- Pediatrics Physician
- Woburn, MA
National Provider Identifier
1306595152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 1022964
- Practice address
- 99 Commerce Way
Woburn, MA 01801-5199 - Phone
- (781) 935-5437
- NPI assigned
- Mar 21, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 1022964 | MA | Primary |
Addresses
Primary practice location
99 Commerce Way
Woburn, MA 01801-5199
Mailing address
99 Commerce Way
Woburn, MA 01801-5199
Other practice location 1
505 S Main St Ste 525
Orange, CA 92868-4553
Phone (714) 456-5631
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1022964 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PM Pediatrics of New England LLC | Pediatrics | Past | Accepting new patients |
| PM Pediatrics of New England LLC | Pediatrics | Past | Accepting new patients |
| PM Pediatrics of New England LLC | Pediatrics | Past | Accepting new patients |
| PM Pediatrics of New England LLC | Past | Accepting new patients | |
| University of California Irvine | Past | Accepting new patients |
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Saugus, MA
- NPI 1477378123
-
- General Acute Care Hospital
- Orange, CA
- NPI 1689608150
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1647820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750723200000",
"number": "1306595152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 COMMERCE WAY",
"city": "WOBURN",
"state": "MA",
"postal_code": "018015199"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 COMMERCE WAY",
"city": "WOBURN",
"state": "MA",
"postal_code": "018015199",
"telephone_number": "781-935-5437"
}
],
"practiceLocations": [
{
"address_1": "505 S Main St Ste 525",
"address_purpose": "LOCATION",
"city": "Orange",
"state": "CA",
"postal_code": "928684553",
"country_code": "US",
"telephone_number": "714-456-5631",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "THIESEN",
"first_name": "TAYLOR",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-03-21",
"last_updated": "2025-06-24",
"certification_date": "2025-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "1022964",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.