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

Scott R Derenne, PA-CPHYSICIANASSI

Individual provider Physician Assistant · NPI 1851303622

Scott R Derenne, PA-CPHYSICIANASSI is a Physician Assistant in Phoenix, Arizona. Licensed in Wisconsin. Registered with an NPI since 2006.

Licensed in
WI
In the registry since
2006
Specialties on file
2

Practice location Address checks out

15225 S 15th Ave
Phoenix, AZ 85045-1904
Phone: (920) 737-4014
Fax: (920) 288-8355
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X
Physician Assistant Taxonomy 363A00000X · Licence 913 (WI)

Record details

NPI number1851303622
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-CPHYSICIANASSI
Sole proprietorNo
NPI enumeratedAugust 12, 2006
Last updated in NPPESJuly 10, 2019

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