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EPIPHANY DERMATOLOGY OF IOWA, PLC
NPI 1104451749
Dermatology in Cedar Rapids, IA

Active since March 04, 2020CLIA 16D0386795 · Certificate of Compliance
5264 COUNCIL ST NE STE 700, CEDAR RAPIDS, IA 52402(319) 363-9963(319) 363-0520 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 7, 2023, Mar 4, 2020 (2 updates tracked since 2020).

About Epiphany Dermatology Of Iowa, Plc NPPES

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

EPIPHANY DERMATOLOGY OF IOWA, PLC (NPI 1104451749) is a healthcare organization registered as a dermatology in Cedar Rapids, Iowa and active in the NPI registry since March 2020. The organization holds a CLIA Certificate of Compliance certificate valid through January 5, 2028 and lists Gheorghe Pusta, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1104451749
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF IOWA, PLC
Location Address5264 COUNCIL ST NE STE 700Cedar Rapids, IA 52402-2477
Mailing Address7300 Ranch Rd. 2222, Bldg 1, Ste 200Austin, TX 78730-3255 · (512) 628-0465
Phone(319) 363-9963
Fax(319) 363-0520
Organization SubpartNo
Authorized OfficialGheorghe PustaExecutive Director · (512) 628-0465
Enumeration DateMarch 4, 2020
Last NPPES UpdateDecember 7, 20232 updates tracked since enumeration
NPPES CertifiedDecember 7, 2023
✔ NPI 1104451749 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.
5264 COUNCIL ST NE STE 700, Cedar Rapids, IA 52402
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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

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from NH Healthy Families, Ambetter from Sunflower Health Plan and more.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 16D0386795

Epiphany Dermatology Of Iowa, Plc · Cedar Rapids, IA
Active · expires Jan 5, 2028
CLIA Number16D0386795
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorJohn H. Wollner
Laboratory Phone(319) 363-9936
Laboratory LocationEpiphany Dermatology Of Iowa, Plc5264 Council St NE Ste 700, Cedar Rapids, IA 52402
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 2

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

DR. JOHN HUGH WOLLNER M.D.
Dermatology
5264 COUNCIL ST NE STE 700
CEDAR RAPIDS, IA 52402
Linn County (319) 363-9936
JOSHUA W ANGLE PA-C
Physician Assistant
5264 COUNCIL ST NE STE 700
CEDAR RAPIDS, IA 52402
Linn County (319) 363-9936

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 Iowa, Plc's NPI number?

The NPI number for Epiphany Dermatology Of Iowa, Plc is 1104451749. It was assigned to this organization in the NPPES registry on March 4, 2020.

Where is Epiphany Dermatology Of Iowa, Plc located?

Epiphany Dermatology Of Iowa, Plc is located at 5264 Council St NE Ste 700, Cedar Rapids, IA 52402. The listed phone number is (319) 363-9963.

What is Epiphany Dermatology Of Iowa, Plc's specialty?

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

Does Epiphany Dermatology Of Iowa, Plc hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 16D0386795) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Epiphany Dermatology Of Iowa, Plc accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from NH Healthy Families and Ambetter from Sunflower Health Plan and 1 other insurer list Epiphany Dermatology Of Iowa, Plc 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 Iowa, Plc was last updated on December 7, 2023. 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.