Active NPI
Andrew Moran, DPT
- Physical Therapist
- Eden Prairie, MN
National Provider Identifier
1487145405
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11086
- Practice address
- 6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356 - Phone
- (952) 224-1919
- Fax
- (612) 999-1943
- NPI assigned
- May 24, 2018
- Sex
- Male
- Sole proprietor
- No
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 | 11086 | MN | Primary |
Addresses
Primary practice location
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Mailing address
6545 Flying Cloud Dr Ste 201
Eden Prairie, MN 55344-3356
Phone (952) 224-1919
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
6545 Flying Cloud Dr
Suite 201
Eden Prairie, MN 55344-3356
Phone (952) 224-1919
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11086 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Odom Sports Medicine, P.a. | Current | Accepting new patients |
Locations
6545 Flying Cloud Dr
Ste 201
Eden Prairie, MN 55344
Phone (612) 364-1901
10653 Wayzata Blvd
Ste 200
Minnetonka, MN 55305
Phone (612) 364-1901
Organizations & group practices 1
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.
-
- Sports Medicine (Family Medicine) Physician
- Eden Prairie, MN
- NPI 1275557886
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777420800000",
"number": "1487145405",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6545 FLYING CLOUD DR STE 201",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443356",
"telephone_number": "952-224-1919",
"fax_number": "612-999-1943"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6545 FLYING CLOUD DR STE 201",
"city": "EDEN PRAIRIE",
"state": "MN",
"postal_code": "553443356",
"telephone_number": "952-224-1919",
"fax_number": "612-999-1943"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "ANDREW",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-24",
"last_updated": "2026-04-29",
"certification_date": "2026-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MN",
"license": "11086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Eden Prairie, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 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.