Individual provider Active NPI

Carli Ceckanowicz, DPT

  • Physical Therapist
  • Belmont, MA
National Provider Identifier
1821771205
Registry record updated Aug 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27045 Issued in MA
Practice address
284 Trapelo Rd
Belmont, MA 02478-1850
Phone
(857) 626-3284
NPI assigned
Aug 10, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 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 27045 MA Primary

Addresses

Primary practice location

284 Trapelo Rd
Belmont, MA 02478-1850

Mailing address

79 Brown St Unit 1
Waltham, MA 02453-3915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230912000344 MA Practitioner - Physical Therapist in Private Practice 1557725470 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

284 Trapelo Rd
Belmont, MA 02478-1850
Phone (857) 626-3284

Merit-based Incentive Payment System (MIPS)

Final score
85.19 of 100Reported as group
Quality
86.04
Improvement activities
40
Cost
76.23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27045MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Aug 9, 2023 Accepting new patients
Performance Rehabilitation of Western New England LLC Physical Therapist CurrentSince Aug 9, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

33377 Collection Ctr Dr
Chicago, IL 60693
Phone (617) 284-9418

101 University Dr
Ste A6
Amherst, MA 01002
Phone (413) 336-5703

284 Trapelo Rd
Belmont, MA 02478
Phone (857) 626-3284

57 Bedford St
Ste 202
Lexington, MA 02420
Phone (781) 541-5111

1092 Lexington St
Waltham, MA 02452
Phone (781) 906-8442

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1691625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691625600000",
    "number": "1821771205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 BROWN ST UNIT 1",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024533915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 TRAPELO RD",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781850",
            "telephone_number": "857-626-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CECKANOWICZ",
        "first_name": "CARLI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-10",
        "last_updated": "2023-08-10",
        "certification_date": "2023-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "27045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.