Individual provider Active NPI

Michael Semancik

  • Physical Therapist
  • Boston, MA
National Provider Identifier
1922666437
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTL27489 Issued in MA
Practice address
660 Beacon St
Boston, MA 02215-2002
Phone
(617) 536-1161
Fax
(844) 283-4933
NPI assigned
May 30, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL27489 MA Primary
Physical Therapist 225100000X 12167 CT

Addresses

Primary practice location

660 Beacon St
Boston, MA 02215-2002

Mailing address

4 Richmond SQ
Providence, RI 02906-5117
Phone (401) 433-4172

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190917002602 CT Practitioner - Physical Therapist in Private Practice 1658600630 Reassigns benefits to 4 organizations
I20240730002252 MA Practitioner - Physical Therapist in Private Practice 1658600630 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Silver Fern Practice LLCGroup PAC ID 1658266515, 297 clinicians
Joint Ventures Physical Therapy IncGroup PAC ID 2163474560, 62 clinicians

Practice addresses (Care Compare)

115 Norwood Park S
Norwood, MA 02062-4633
Phone (781) 702-4630

648 Beacon St
Boston, MA 02215-2013
Phone 61753611611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12167CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Aug 23, 2025 Accepting new patients
Performance Physical Therapy of Darien LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Performance Physical Therapy of New Canaan, PLLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients
Joint Ventures Physical Therapy, Inc. CurrentSince Jul 22, 2024 Accepting new patients
Performance Physical Therapy of CT Physical Therapist CurrentSince Mar 18, 2024 Accepting new patients
Silver Fern Practice, LLC Physical Therapist CurrentSince Aug 23, 2025 Accepting new patients
Joint Ventures Physical Therapy, Inc. Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Performance Physical Therapy of Westport LLC Physical Therapist CurrentSince Aug 1, 2019 Accepting new patients

Locations

35 River Rd
Cos Cob, CT 06807
Phone (203) 629-5800

800 Post Rd
#3A
Darien, CT 06820
Phone (203) 202-2703

16 Cross St
New Canaan, CT 06840
Phone (203) 228-5010

508 Westport Ave
Norwalk, CT 06851
Phone (203) 553-7626

9 W Broad St
Ste 100
Stamford, CT 06902

9 W Broad St
Fl 1
Stamford, CT 06902

1395 Commerce Way
Ste 112
Attleboro, MA 02703
Phone (508) 455-5740

648 Beacon St
Boston, MA 02215
Phone (617) 353-9345

660 Beacon St
Boston, MA 02215
Phone (617) 536-1160

660 Beacon St
Ste B1
Boston, MA 02215

115 Norwood Park S
Norwood, MA 02062
Phone (781) 349-5181

4 Richmond Sq
Ste 200
Providence, RI 02906

4 Richmond Sq
Providence, RI 02906
Phone (401) 885-2821

Organizations & group practices 9

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1922666437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 RICHMOND SQ",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065117",
            "telephone_number": "401-433-4172",
            "fax_number": "401-433-0612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "660 BEACON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022152002",
            "telephone_number": "617-536-1161",
            "fax_number": "844-283-4933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMANCIK",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-30",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "PTL27489",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12167",
            "primary": false
        }
    ],
    "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 Oct 15, 2025; 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.