Individual provider Active NPI

Andrew Tomas Cordova, PT

  • Physical Therapist
  • Mankato, MN
National Provider Identifier
1740012111
Registry record updated Mar 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13664 Issued in MN
Practice address
1025 Marsh St
Mankato, MN 56001-4752
Phone
(507) 625-4031
NPI assigned
Aug 15, 2024
Last updated
Mar 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 12183 SC
Physical Therapist 225100000X 19784 CO
Physical Therapist 225100000X 14255 CT
Physical Therapist 225100000X 13664 MN Primary

Addresses

Primary practice location

1025 Marsh St
Mankato, MN 56001-4752

Mailing address

PO Box 860912
Minneapolis, MN 55486-0912
Phone (507) 284-2511

Other practice location 1

30940 Stagecoach Blvd # 110
Evergreen, CO 80439-7984
Phone (860) 830-3715

Other practice location 2

111 Carkoski Cmns
Mankato, MN 56001-6031
Phone (860) 830-3715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, MN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250513001469 CO Practitioner - Physical Therapist in Private Practice 1153849278 Reassigns benefits to 1 organization
I20251211004059 MN Practitioner - Physical Therapist in Private Practice 1153849278 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Minneapolis, MN 55486

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12183SCMDOrthopaedic Surgery of the Spine Physician
19784COMDPhysical Therapist
14255CTMDPhysical Therapist
13664MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Select Physical Therapy of West Denver Limited Partnership Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Sep 22, 2025 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Sep 22, 2025 Accepting new patients
Select Physical Therapy of West Denver Limited Partnership CurrentSince Apr 1, 2025 Accepting new patients
Select Physical Therapy of West Denver Limited Partnership CurrentSince Apr 1, 2025 Accepting new patients
Select Physical Therapy Holdings Inc Physical Therapist Past Accepting new patients

Locations

30940 Stagecoach Blvd
#110
Evergreen, CO 80439
Phone (303) 674-1594

8601 Turnpike Dr
Ste 204
Westminster, CO 80031
Phone (570) 417-7622

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

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.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773360000000",
    "number": "1740012111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860912",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554860912",
            "telephone_number": "507-284-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 MARSH ST",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560014752",
            "telephone_number": "507-625-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30940 Stagecoach Blvd # 110",
            "address_purpose": "LOCATION",
            "city": "Evergreen",
            "state": "CO",
            "postal_code": "804397984",
            "country_code": "US",
            "telephone_number": "860-830-3715",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Carkoski Cmns",
            "address_purpose": "LOCATION",
            "city": "Mankato",
            "state": "MN",
            "postal_code": "560016031",
            "country_code": "US",
            "telephone_number": "860-830-3715",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CORDOVA",
        "first_name": "ANDREW",
        "middle_name": "TOMAS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-15",
        "last_updated": "2026-03-13",
        "certification_date": "2026-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "12183",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "19784",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "14255",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MN",
            "license": "13664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mankato, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.

Verify at the official NPI Registry.