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

Mr. Samuel Perenich, PA

Individual provider Physician Assistant · NPI 1467270009

Mr. Samuel Perenich, PA is a Physician Assistant in Hazle Township, Pennsylvania. Qualified in 2024, 2 years ago. Practices with Advanced Dermatology of Pennsylvania, PC, a 28-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida.

Years since qualifying
2
Licensed in
FL
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

631 Airport Rd Ste 100
Hazle Township, PA 18202-3379
Phone: (570) 454-7546
Fax: (570) 455-7547
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 7547 Jacque Rd, Hudson, FL 34667-7163 — (727) 862-8561

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA9119155 (FL)

Record details

NPI number1467270009
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedOctober 2, 2024
Last updated in NPPESDecember 3, 2025
Certification dateDecember 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Advanced Dermatology Of Pennsylvania, Pc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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