Active NPI
Harold Christian Doriman Gravador
- Physical Therapist
- Flushing, NY
National Provider Identifier
1174300305
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 048563
- Practice address
- 14204 Bayside Ave Ste 8L
Flushing, NY 11354-2300 - Phone
- (718) 445-6477
- NPI assigned
- Sep 12, 2023
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 048563 | NY | Primary |
Addresses
Primary practice location
14204 Bayside Ave Ste 8L
Flushing, NY 11354-2300
Mailing address
6550 Wetherole St Apt 5W
Rego Park, NY 11374-4720
Phone (929) 504-8462
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
14204 Bayside Ave
Suite 8L
Flushing, NY 11354-2300
Phone (718) 445-6477
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048563 | NY | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kinesioworks Physical Therapy, P.C. | Physical Therapist | Current | Accepting new patients |
| Function in Motion Physical Therapy PC | Physical Therapist | Past | Accepting new patients |
Locations
1980 Amsterdam Ave
Unit 1B
New York, NY 10032
Phone (212) 740-2049
Organizations & group practices 3
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.
-
- Primary Care Clinic/Center
- Flushing, NY
- NPI 1265721435
-
- Physical Therapist
- New York, NY
- NPI 1487110888
-
- Physical Therapist
- Bronx, NY
- NPI 1316331200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773878400000",
"number": "1174300305",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6550 WETHEROLE ST APT 5W",
"city": "REGO PARK",
"state": "NY",
"postal_code": "113744720",
"telephone_number": "929-504-8462"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14204 BAYSIDE AVE STE 8L",
"city": "FLUSHING",
"state": "NY",
"postal_code": "113542300",
"telephone_number": "718-445-6477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAVADOR",
"first_name": "HAROLD CHRISTIAN",
"middle_name": "DORIMAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-09-12",
"last_updated": "2026-03-19",
"certification_date": "2026-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "048563",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Flushing, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2026; 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.