Organization Active NPI

Lindsey Ma, MD, SC

  • Gynecology Physician
  • Peoria, IL
National Provider Identifier
1821180688
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
Legal business name
LINDSEY MA, MD, SC
Practice address
3300 W Willow Knolls Dr
Peoria, IL 61614-8121
Phone
(309) 683-0200
Fax
(309) 683-0201
NPI assigned
Sep 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Authorized official

Name
Mr. Lindsey Ma, MDNPI 1285688820
Title
President
Phone
(309) 683-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VG0400X IL Primary
Obstetrics PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207VX0000X IL

Addresses

Primary practice location

3300 W Willow Knolls Dr
Peoria, IL 61614-8121

Mailing address

3300 W Willow Knolls Dr
Peoria, IL 61614-8121
Phone (309) 683-0200

Other identifiers 1

IdentifierTypeStateIssuer
07232118OtherILBCBS GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051121000314 IL Part B Supplier - Clinic/Group Practice 6204855158 Receives reassigned benefits from 2 practitioners
Practice locations: Peoria, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2237335Lindsey Ma MD SC3300 W Willow Knolls Dr - Unit 2, Peoria, IL 61614Certificate of waiverSep 22, 2027

National Provider Directory

National Provider Directory

Locations

5401 N Knoxville Ave
Ste 109
Peoria, IL 61614
Phone (309) 692-2805

3300 W Willow Knolls Dr
Peoria, IL 61614
Phone (309) 683-0200

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666224000000",
    "number": "1821180688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148121",
            "telephone_number": "309-683-0200",
            "fax_number": "309-683-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 W WILLOW KNOLLS DR",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616148121",
            "telephone_number": "309-683-0200",
            "fax_number": "309-683-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDSEY MA, MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A",
        "authorized_official_last_name": "MA",
        "authorized_official_first_name": "LINDSEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-683-0200",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "07232118",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.