DERREK GIANSIRACUSA
NPI 1154023737
Dermatology in Glendale, AZ

Q: What is Derrek Giansiracusa's NPI number?

The NPI number for Derrek Giansiracusa is 1154023737. It was assigned to this individual provider in the NPPES registry on March 20, 2023.

Q: What is Derrek Giansiracusa's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Active since March 20, 2023PECOS EnrolledAccepts Medicare Assignment

11851 N 51ST AVE STE E130, GLENDALE, AZ 85304(623) 299-9540 Get Directions Write a Review

NPPES record last updated: March 25, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 25, 2025, Mar 20, 2023 (2 updates tracked since 2023).

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About Derrek Giansiracusa NPPES

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

DERREK GIANSIRACUSA (NPI 1154023737) is an individual dermatology provider in Glendale, Arizona, licensed in Arizona (011498) and active in the NPI registry since March 2023. He is enrolled in Medicare PECOS and is a graduate of Lake Erie College Of Osteopathic Medicine, Bradenton (2023).

NPPES Registry Identity

NPI1154023737

Entity TypeIndividualMale

Primary Taxonomy207N00000X

Provider Legal NameDERREK GIANSIRACUSA

Location Address11851 N 51ST AVE STE E130Glendale, AZ 85304-2843

Mailing Address11851 N 51st Ave Ste E130Glendale, AZ 85304-2843

Phone(623) 299-9540

Sole ProprietorYes

Medical School CMSLake Erie College Of Osteopathic Medicine, BradentonGraduated 2023

Enumeration DateMarch 20, 2023

Last NPPES UpdateMarch 25, 20252 updates tracked since enumeration

NPPES CertifiedMarch 25, 2025

✔ NPI 1154023737 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians

Taxonomy Code207N00000X

License✔ Licensed in AZ · 011498

Definition

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

11851 N 51ST AVE STE E130, Glendale, AZ 85304

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Derrek Giansiracusa 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 ID6709248768

PECOS Enrollment IDI20250311000214

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 Reassignment

Medicare enrollment records show Derrek Giansiracusa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Omni Dermatology Incorporated

Same address

Dermatology

11851 N 51ST AVE STE E130
Glendale, AZ 85304

Reassigned Medicare billing, Arizona enrollment
15 clinicians in this Medicare group

NPI 1003082090 (480) 954-3919

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 85304 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

$85.89 typical visit price

range $55.44 – $168.60

Typical copayment $21.47 (range $13.86 – $42.15)

Most-billed visit code 99203

Established Patient

$69.24 typical visit price

range $17.72 – $137.41

Typical copayment $17.31 (range $4.43 – $34.35)

Most-billed visit code 99213

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 6

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

OMNI DERMATOLOGY INCORPORATED

Dermatology