Individual provider Active NPI

Christina Marie Gavalas, MSOT, OTR/L

  • Occupational Therapist
  • Manhasset, NY
National Provider Identifier
1861039901
Registry record updated Dec 9, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
022019 Issued in NY
Practice address
1554 Northern Blvd FL 3
Manhasset, NY 11030-3054
Phone
(516) 719-3164
NPI assigned
Dec 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 022019 NY Primary

Addresses

Primary practice location

1554 Northern Blvd FL 3
Manhasset, NY 11030-3054

Mailing address

952 Van Buren Ave
Franklin Square, NY 11010-2118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241211001146 NY Practitioner - Occupational Therapist in Private Practice 6002342268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Oct 4, 2024 Accepting new patients
Sports Physical Therapy Occupational Therapy and Rehabilitation Servic Occupational Therapist CurrentSince Oct 4, 2024 Accepting new patients

Locations

145 Community Dr
Great Neck, NY 11021
Phone (516) 465-8260

972 Brush Hollow Rd
Westbury, NY 11590

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": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1861039901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "952 VAN BUREN AVE",
            "city": "FRANKLIN SQUARE",
            "state": "NY",
            "postal_code": "110102118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 NORTHERN BLVD FL 3",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110303054",
            "telephone_number": "516-719-3164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVALAS",
        "first_name": "CHRISTINA",
        "middle_name": "MARIE",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NY",
            "license": "022019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manhasset, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.