CONNIE ANJOLI DESARDEN M.D.
NPI 1306100227
Internal Medicine in Wauwatosa, WI

Q: What is Connie Desarden's NPI number?

The NPI number for Connie Desarden is 1306100227. It was assigned to this individual provider in the NPPES registry on June 26, 2012.

Q: What is Connie Desarden's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: Is Connie Desarden enrolled in Medicare?

No. Connie Desarden has opted out of Medicare through July 3, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Connie Desarden was last updated on February 1, 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 June 26, 2012Opted out of Medicare · through Jul 3, 2027

3289 N MAYFAIR RD, WAUWATOSA, WI 53222(414) 771-7900(414) 607-6336 Get Directions Write a Review

NPPES record last updated: February 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Feb 1, 2022, Nov 3, 2017 (2 updates tracked since 2017).

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About Connie Anjoli Desarden M.d. NPPES

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

CONNIE ANJOLI DESARDEN M.D. (NPI 1306100227) is an individual internal medicine provider in Wauwatosa, Wisconsin, licensed in Wisconsin (67984) and active in the NPI registry since June 2012. She has opted out of Medicare through July 3, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1306100227

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NameCONNIE ANJOLI DESARDENCredential: M.D.

Location Address3289 N MAYFAIR RDWauwatosa, WI 53222-3203

Mailing Address3289 N Mayfair RdWauwatosa, WI 53222-3203 · (414) 771-7900 · Fax (414) 607-6336

Phone(414) 771-7900

Fax(414) 607-6336

Sole ProprietorNo

Enumeration DateJune 26, 2012

Last NPPES UpdateFebruary 1, 20222 updates tracked since enumeration

✔ NPI 1306100227 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WI · 67984

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

3289 N MAYFAIR RD, Wauwatosa, WI 53222

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Connie Anjoli Desarden M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 3, 2023 through July 3, 2027.

Opt-Out Effective DateJuly 3, 2023

Opt-Out In Effect ThroughJuly 3, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53222 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

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.

GEETHA GANESAN M.D.

Internal Medicine