Individual provider Active NPI

Vera Menchikova

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1477234367
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL26931 Issued in MA
Practice address
665 Boylston Street
Third Floor
Boston, MA 02116
Phone
(617) 600-8071
NPI assigned
Jul 25, 2023
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL26931 MA Primary

Addresses

Primary practice location

665 Boylston Street
Third Floor
Boston, MA 02116

Mailing address

665 Boylston St
Third Floor
Boston, MA 02116-4825
Phone (617) 600-8071

Other practice location 1

1493 Cambridge St
Cambridge, MA 02139-1099
Phone (617) 665-1000

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

State licenses

LicenseStateTypeSpecialty
PTL26931MAMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1690243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1477234367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 BOYLSTON ST",
            "address_2": "THIRD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021164825",
            "telephone_number": "617-600-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 BOYLSTON STREET",
            "address_2": "THIRD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02116",
            "telephone_number": "617-600-8071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1493 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MA",
            "postal_code": "021391099",
            "country_code": "US",
            "telephone_number": "617-665-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENCHIKOVA",
        "first_name": "VERA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-25",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL26931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.