Individual provider Active NPI

Connie Ma, MD

  • Otolaryngology Physician
  • Creve Coeur, MO
National Provider Identifier
1992387385
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
2026003802 Issued in MO
Practice address
1044 N Mason Rd
Dept Otolaryngology, Ste L10
Creve Coeur, MO 63141-6431
Phone
(314) 996-3880
Fax
(314) 996-8610
NPI assigned
Apr 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 2026003802 MO Primary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 2026003802 MO

Addresses

Primary practice location

1044 N Mason Rd
Dept Otolaryngology, Ste L10
Creve Coeur, MO 63141-6431

Mailing address

PO Box 7412001
Chicago, IL 60674-2011
Phone (314) 996-3880

Other identifiers 1

IdentifierTypeStateIssuer
200174541MedicaidMO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260627000600 MO Practitioner - Otolaryngology 2466855564

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Texas Southwestern Medical School at Dallas, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

660 S Euclid Ave
Saint Louis, MO 63110-1010

National Provider Directory

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

Interoperability endpoints

  • Direct secure messaging: cma652120@direct.vumc.org

NPI Registry JSON

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

{
    "created_epoch": "1619308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1992387385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7412001",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606742011",
            "telephone_number": "314-996-3880",
            "fax_number": "314-996-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1044 N MASON RD",
            "address_2": "DEPT OTOLARYNGOLOGY, STE L10",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416431",
            "telephone_number": "314-996-3880",
            "fax_number": "314-996-8610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MA",
        "first_name": "CONNIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-25",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "2026003802",
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "MO",
            "license": "2026003802",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200174541",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

Verify at the official NPI Registry.