EPIPHANY DERMATOLOGY OF WASHINGTON PLLC
NPI 1053142778
Dermatology in Mercer Island, WA

Active since August 13, 2024CLIA 50D2317185 · Certificate of Compliance
7707 SE 27TH ST STE 104, MERCER ISLAND, WA 98040(512) 628-0465 Get Directions Write a Review

NPPES record last updated: August 13, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Epiphany Dermatology Of Washington Pllc NPPES

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

EPIPHANY DERMATOLOGY OF WASHINGTON PLLC (NPI 1053142778) is a healthcare organization registered as a dermatology in Mercer Island, Washington and active in the NPI registry since August 2024. The organization holds a CLIA Certificate of Compliance certificate valid through April 4, 2028 and lists Gheorghe Pusta, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1053142778
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF WASHINGTON PLLC
Location Address7707 SE 27TH ST STE 104Mercer Island, WA 98040-2844
Mailing Address7300 Ranch Road 2222, Bldg 1, Ste 200Austin, TX 78730-3255 · (512) 628-0465 · Fax (512) 233-2711
Organization SubpartNo
Authorized OfficialGheorghe PustaExecutive Director · (512) 628-0465
Enumeration DateAugust 13, 2024
NPPES CertifiedAugust 13, 2024
NPI 1053142778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
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.
7707 SE 27TH ST STE 104, Mercer Island, WA 98040

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

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 50D2317185

Epiphany Dermatology · Mercer Island, WA
Active · expires Apr 4, 2028
CLIA Number50D2317185
Laboratory TypePhysician Office
Certificate Effective DateJanuary 28, 2025
Certificate Expiration DateApril 4, 2028
Laboratory DirectorKelly A. Griffith-Bauer
Laboratory Phone(206) 232-2267
Laboratory LocationEpiphany Dermatology7707 SE 27th St Ste 104, Mercer Island, WA 98040
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

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

Dermatology
7707 SE 27TH ST STE 104
MERCER ISLAND, WA 98040
Dermatology
7707 SE 27TH ST STE 104
MERCER ISLAND, WA 98040
Dermatology
7707 SE 27TH ST STE 104
MERCER ISLAND, WA 98040

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Epiphany Dermatology Of Washington PLLC's NPI number?

The NPI number for Epiphany Dermatology Of Washington PLLC is 1053142778. It was assigned to this organization in the NPPES registry on August 13, 2024.

Where is Epiphany Dermatology Of Washington PLLC located?

Epiphany Dermatology Of Washington PLLC is located at 7707 SE 27th St Ste 104, Mercer Island, WA 98040. The listed phone number is (512) 628-0465.

What is Epiphany Dermatology Of Washington PLLC's specialty?

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

Does Epiphany Dermatology Of Washington PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 50D2317185) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Epiphany Dermatology Of Washington PLLC accept?

Health plans from Premera Blue Cross Blue Shield of Alaska list Epiphany Dermatology Of Washington PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Epiphany Dermatology Of Washington PLLC was last updated on August 13, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.