Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Derek J. Taylor, PA-C

Individual provider Surgical Physician Assistant · NPI 1093111304

Derek J. Taylor, PA-C is a Physician Assistant in Mesa, Arizona. Qualified in 2014, 12 years ago. Practices with Valleywide Surgical Services, LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
12
Licensed in
AZ
In the registry since
2014
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4320 E Presidio St #101
Mesa, AZ 85215-3031
Phone: (480) 706-9430
Fax: (480) 378-2273
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5941 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X (AZ)

Record details

NPI number1093111304
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 13, 2014
Last updated in NPPESApril 19, 2018

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Valleywide Surgical Services, Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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