EPIPHANY DERMATOLOGY OF OREGON, LLC
NPI 1174697239
Dermatology in Portland, OR
About Epiphany Dermatology Of Oregon, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EPIPHANY DERMATOLOGY OF OREGON, LLC (NPI 1174697239) is a healthcare organization registered as a dermatology in Portland, Oregon and active in the NPI registry since November 2006. The organization holds a CLIA Microscopy certificate valid through September 8, 2028 and lists Gheorghe Pusta, Secretary, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Epiphany Dermatology Of Oregon, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Epiphany Dermatology Of Oregon, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 for Provider-Performed Microscopy Procedures (PPMP) 38D0954415
Epiphany Dermatology Of Oregon, LLC · Portland, ORFrequently 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 Oregon, LLC's NPI number?
The NPI number for Epiphany Dermatology Of Oregon, LLC is 1174697239. It was assigned to this organization in the NPPES registry on November 20, 2006.
Where is Epiphany Dermatology Of Oregon, LLC located?
Epiphany Dermatology Of Oregon, LLC is located at 2222 NW Lovejoy St Suite 422, Portland, OR 97210. The listed phone number is (503) 227-7117.
What is Epiphany Dermatology Of Oregon, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Epiphany Dermatology Of Oregon, LLC enrolled in Medicare?
Yes. Epiphany Dermatology Of Oregon, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Epiphany Dermatology Of Oregon, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Dermatology, reassign their Medicare billing to Epiphany Dermatology Of Oregon, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Epiphany Dermatology Of Oregon, LLC hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 38D0954415) is associated with this NPI, valid through September 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Epiphany Dermatology Of Oregon, LLC accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Epiphany Dermatology Of Oregon, LLC 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 Oregon, LLC was last updated on July 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Epiphany Dermatology Of Oregon, Llc · NPI 1174697239
Dermatology organization in Portland, Oregon. Organization record, active in the CMS NPPES registry since November 20, 2006.
## Identity
- **NPI:** 1174697239 (Entity type: Organization)
- **Enumerated:** November 20, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Organization subpart:** No
- **Authorized official:** Gheorghe Pusta, SECRETARY
## Practice location
- **Address:** 2222 NW LOVEJOY ST, SUITE 422, Portland, OR 97210-3033
- **Phone:** (503) 227-7117 · **Fax:** (503) 227-7120
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 21, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1174697239) · Data from the CMS NPPES public registry.