Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Derrek Giansiracusa

Individual provider Dermatology Physician · NPI 1154023737

Derrek Giansiracusa is a Dermatology in Glendale, Arizona. Graduated from Lake Erie College of Osteopathic Medicine, Bradenton in 2023, 3 years ago. Practices with Omni Dermatology Incorporated, a 13-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
3
Trained at
Lake Erie College of Osteopathic Medicine, Bradenton
Licensed in
AZ
In the registry since
2023
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Practice location Address checks out

11851 N 51st Ave Ste E130
Glendale, AZ 85304-2843
Phone: (623) 299-9540
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence 011498 (AZ)

Record details

NPI number1154023737
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 20, 2023
Last updated in NPPESMarch 25, 2025
Certification dateMarch 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolLAKE ERIE COLLEGE OF OSTEOPATHIC MEDICINE, BRADENTON
Graduated 2023 (3 years in practice)
Group practice Omni Dermatology Incorporated — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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