GASTON D CORDOVA (PT) – Physical Therapist, NPI 1205928710

GASTON D CORDOVA (PT) is a healthcare provider. based in Willow springs, Illinois. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 070014706 (IL). The NPI Number for GASTON D CORDOVA (PT) is 1205928710

Main info

Male
21 Years Of Experience
Accepts Medicare Assignment
Name
GASTON D CORDOVA (PT)
NPI
1205928710
Phone
Not provided
Address
121 SANTA FE LN
Enumeration Date
29 September 2006
Last Update Date
26 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6305817775
Graduation Year
2005 (21 years ago)
PAC ID
9537174032
Group Practice PAC ID
2163339722
Professional Enrollment ID
I20060220000195
Address ID
IL605276956BU15XXXRDXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

5,028 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IL

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Provider Addresses for GASTON D CORDOVA (PT)

  • 121, Santa Fe Lane, Windings of Willow Ridge, Willow Springs, Lyons Township, Cook County, Illinois, 60480, United States

    WILLOW SPRINGS, IL 604801624

    Phone:

    Type: Mailing

  • The Pearl at The Tillers, 4390, IL 71, Oswego, Oswego Township, Kendall County, Illinois, 60543, United States

    OSWEGO, IL 60543

    Phone: (630) 554-1001

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-02-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20060220000195IPhysical Therapist In Private PracticeILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60480)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2163339722View full group profile
NameSpecialtyState
Internal MedicineVA
-NY
Nurse PractitionerMI
Family PracticeTX
Physician AssistantNC
Internal Medicine, Geriatric MedicineNC
Qualified Speech Language PathologistOK
Occupational Therapist In Private PracticeNC
Internal MedicineNC
Internal MedicineNC

Reviews

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Frequently asked questions

How is GASTON D CORDOVA (PT) identified in CMS data?
CMS-hosted NPPES data lists GASTON D CORDOVA (PT) with NPI 1205928710.
Does the file indicate GASTON D CORDOVA (PT) is practicing under active NPI?
Directory data currently reports GASTON D CORDOVA (PT) as active.
What is GASTON D CORDOVA (PT)'s primary classification?
Physical Therapist is the headline specialty for GASTON D CORDOVA (PT) here. Clinical services aligned with this taxonomy classification.
What area does GASTON D CORDOVA (PT) serve?
GASTON D CORDOVA (PT)'s listing highlights Willow Springs, Illinois; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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