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SANDRA M ARCE-GARZON M.D.
NPI 1669477394
Pediatrics in Milwaukee, WI

Active since June 17, 2005PECOS Enrolled
4220 S 27TH ST STE 200, MILWAUKEE, WI 53221(414) 282-5810(414) 282-5468 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Sandra M Arce-garzon M.d. NPPES

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

SANDRA M ARCE-GARZON M.D. (NPI 1669477394) is an individual pediatrics provider in Milwaukee, Wisconsin, licensed in Wisconsin (47372) and active in the NPI registry since June 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1669477394
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSANDRA M ARCE-GARZONCredential: M.D.
Location Address4220 S 27TH ST STE 200Milwaukee, WI 53221-1855
Mailing Address4220 S 27th St. Ste 200Milwaukee, WI 53221-1855 · (414) 282-5810 · Fax (414) 282-5468
Phone(414) 282-5810
Fax(414) 282-5468
Sole ProprietorYes
Enumeration DateJune 17, 2005
Last NPPES UpdateMarch 7, 2023
✔ NPI 1669477394 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in WI · 47372
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
4220 S 27TH ST STE 200, Milwaukee, WI 53221
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Other Names 1

Former Name (1)Sandra M Arce-betancourt M.d

Other Identifiers 6

Other7281612WI · Aetna
Other7689455WI · Cigna
Other2277365WI · Ccn
Medicaid34595700WI
Other1200986WI · Compcare/ipn
Other2276529WI · First Health Care

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Sandra M Arce-garzon M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Sandra Arce-garzon reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc.
122 mi
Clinic/Center
205 S MAIN ST
Iola, WI 54945
  • Reassigned Medicare billing, Wisconsin enrollment
  • 935 clinicians in this Medicare group
NPI 1578232849 (715) 445-4801
Aspirus Stevens Point Hospital & Clinics, Inc.
132 mi
General Practice
3500 HOOVER RD
Stevens Point, WI 54481
  • Reassigned Medicare billing, Wisconsin enrollment
  • 619 clinicians in this Medicare group
NPI 1184082745 (715) 342-7900

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53221 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
$82.92 typical visit price
range $53.90 – $163.24
Typical copayment $20.73 (range $13.47 – $40.81)
Most-billed visit code 99203
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

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

DR. STANLEY SIROTINSKI D.D.S
Dentist (General Practice)
4220 S 27TH ST STE 200
MILWAUKEE, WI 53221
Milwaukee County (414) 282-4211

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sandra Arce-garzon's NPI number?

The NPI number for Sandra Arce-garzon is 1669477394. It was assigned to this individual provider in the NPPES registry on June 17, 2005. The provider is also known as Sandra M Arce-Betancourt M.D.

Where is Sandra Arce-garzon located?

Sandra Arce-garzon practices at 4220 S 27th St Ste 200, Milwaukee, WI 53221. The listed phone number is (414) 282-5810.

What is Sandra Arce-garzon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Sandra Arce-garzon enrolled in Medicare?

Yes. Sandra Arce-garzon is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Sandra Arce-garzon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sandra Arce-garzon reassigns Medicare benefits to 2 organizations: Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. (Iola, WI) and Aspirus Stevens Point Hospital & Clinics, Inc. (Stevens Point, WI). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sandra Arce-garzon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sandra Arce-garzon accept?

Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, HealthPartners and Security Health Plan list Sandra Arce-garzon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sandra Arce-garzon was last updated on March 7, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.