DR. KAREN HSIA MA MD, PHARMD
NPI 1124464789
Internal Medicine - Gastroenterology in Elmhurst, IL

Q: What is Karen Ma's NPI number?

The NPI number for Karen Ma is 1124464789. It was assigned to this individual provider in the NPPES registry on May 21, 2013.

Q: What is Karen Ma's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Q: When was this NPI record last updated?

The NPPES record for Karen Ma was last updated on January 13, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 21, 2013PECOS EnrolledAccepts Medicare Assignment

91.35/100

CMS Quality Rating

155 E BRUSH HILL RD, ELMHURST, IL 60126(331) 221-9003(331) 221-2743 Get Directions Write a Review

NPPES record last updated: January 13, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 13, 2022, Apr 12, 2021, Jul 29, 2019 (3 updates tracked since 2019).

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About Dr. Karen Hsia Ma Md, Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KAREN HSIA MA MD, PHARMD (NPI 1124464789) is an individual gastroenterology provider in Elmhurst, Illinois, licensed in Illinois (036-139551) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS, is affiliated with Swedish Hospital, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1124464789

Entity TypeIndividualFemale

Primary Taxonomy207RG0100X

Provider Legal NameDR. KAREN HSIA MACredential: MD, PHARMD

Location Address155 E BRUSH HILL RDElmhurst, IL 60126-5658

Mailing Address4201 Winfield RdWarrenville, IL 60555-4025 · (331) 221-6377 · Fax (331) 221-2357

Phone(331) 221-9003

Fax(331) 221-2743

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateMay 21, 2013

Last NPPES UpdateJanuary 13, 20223 updates tracked since enumeration

NPPES CertifiedJanuary 13, 2022

✔ NPI 1124464789 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians

Taxonomy Code207RG0100X

License✔ Licensed in IL · 036-139551

Definition

An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.

155 E BRUSH HILL RD, Elmhurst, IL 60126

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Karen Hsia Ma Md, Pharmd is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID244522597

PECOS Enrollment IDI20190819003860

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 10

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233

Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.

385 services211 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

327 services299 patients

Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239

This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.

48 services46 patients

Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235

This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.

47 services45 patients

Diagnostic exam of large bowel using a flexible endoscope 45378

This procedure, known as a colonoscopy, involves using a flexible tube with a light and camera to examine the large intestine. It helps detect any abnormalities such as polyps or inflammation. It's a standard procedure to ensure gut health.

28 services28 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

21 services21 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Swedish Hospital

Acute Care Hospitals · Chicago, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140114

Location5145 N California AveChicago, IL 60625 · Cook County

Emergency services Birthing friendly

Elmhurst Memorial Hospital

Acute Care Hospitals · Elmhurst, IL

4/5 CMS rating

OwnershipProprietary

CMS Certification Number140200

Location155 East Brush Hill RoadElmhurst, IL 60126 · Du Page County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60126 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$137.43 typical visit price

range $59.81 – $181.38

Typical copayment $34.35 (range $14.95 – $45.34)

Most-billed visit code 99204

Established Patient

$105.07 typical visit price

range $19.15 – $147.12

Typical copayment $26.26 (range $4.78 – $36.78)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

91.35/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.71

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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