NPIMap

Individual provider Active NPI

Andrew G Cordista, MD

  • Orthopaedic Surgery of the Spine Physician
  • Moultrie, GA
National Provider Identifier
1295745081
Registry record updated Sep 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
License
051451 Issued in GA
Practice address
8 Live Oak CT
Moultrie, GA 31768-6783
Phone
(229) 890-6612
Fax
(229) 890-6621
NPI assigned
Aug 8, 2006
Last updated
Sep 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery of the Spine Physician 207XS0117X 051451 GA Primary

Addresses

Primary practice location

8 Live Oak CT
Moultrie, GA 31768-6783

Mailing address

PO Box 2876
Moultrie, GA 31776-2876
Phone (229) 890-6612

Other practice location 1

3131 S Main St
Moultrie, GA 31768-6925
Phone (229) 890-6612

Other practice location 2

9 Hospital Park
Moultrie, GA 31768-6772
Phone (229) 890-6612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040204000534 GA Practitioner - Orthopedic Surgery 2769375799 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
University of Florida College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Colquitt Regional Spine LLCGroup PAC ID 8123249224, 2 clinicians

Practice addresses (Care Compare)

8 Live Oak CT
Moultrie, GA 31768-6783
Phone (229) 890-6612

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion41
Laminectomy or laminotomy (partial removal of spine bones)12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
051451GAMDOrthopaedic Surgery of the Spine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Colquitt Regional Medical Center CurrentSince Apr 20, 2024 Accepting new patients
Colquitt Regional Medical Center CurrentSince Apr 20, 2024 Accepting new patients
Colquitt Regional Pathology, LLC Current Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

3131 Thomasville Hwy
Moultrie, GA 31768
Phone (229) 502-9769

9 Hospital Park
Moultrie, GA 31768
Phone (229) 890-1442

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757289600000",
    "number": "1295745081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2876",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317762876",
            "telephone_number": "229-890-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 LIVE OAK CT",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317686783",
            "telephone_number": "229-890-6612",
            "fax_number": "229-890-6621"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3131 S Main St",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686925",
            "country_code": "US",
            "telephone_number": "229-890-6612",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9 Hospital Park",
            "address_purpose": "LOCATION",
            "city": "Moultrie",
            "state": "GA",
            "postal_code": "317686772",
            "country_code": "US",
            "telephone_number": "229-890-6612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDISTA",
        "first_name": "ANDREW",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2025-09-08",
        "certification_date": "2025-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": "GA",
            "license": "051451",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

Verify at the official NPI Registry.