EPIPHANY DERMATOLOGY OF GEORGIA, LLC
NPI 1265544357
Dermatology in Fayetteville, GA
About Epiphany Dermatology Of Georgia, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
EPIPHANY DERMATOLOGY OF GEORGIA, LLC (NPI 1265544357), doing business as Epiphany Dermatology, is a healthcare organization registered as a dermatology in Fayetteville, Georgia and active in the NPI registry since August 2006. The organization holds 5 active CLIA laboratory certificates and lists Gheorghe Pusta, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
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 Georgia, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
13Medicare enrollment records show 13 clinicians reassign Medicare billing to Epiphany Dermatology Of Georgia, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (13)
Greensboro, GA 30642
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 5
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 11D0686950
Epiphany Dermatology Of Georgia,llc · Newnan, GACertificate for Provider-Performed Microscopy Procedures (PPMP) 11D2075618
Epiphany Dermatology Of Georgia, LLC · Peachtree City, GACertificate of Compliance 11D2288458
Epiphany Dermatology Of Georgia, LLC · Atlanta, GACertificate of Compliance 11D2232160
Epiphany Dermatology Of Georgia,llc · Fayetteville, GACertificate for Provider-Performed Microscopy Procedures (PPMP) 11D2274388
Epiphany Dermatology Of Georgia, LLC · Newnan, GAFrequently 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 Georgia, LLC's NPI number?
The NPI number for Epiphany Dermatology Of Georgia, LLC is 1265544357. It was assigned to this organization in the NPPES registry on August 31, 2006. The provider is doing business as Epiphany Dermatology.
Where is Epiphany Dermatology Of Georgia, LLC located?
Epiphany Dermatology Of Georgia, LLC is located at 874 Lanier Ave W Ste 270, Fayetteville, GA 30214. The listed phone number is (770) 251-5111.
What is Epiphany Dermatology Of Georgia, LLC's specialty?
The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.
Is Epiphany Dermatology Of Georgia, LLC enrolled in Medicare?
Yes. Epiphany Dermatology Of Georgia, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Epiphany Dermatology Of Georgia, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 13 clinicians, all in Dermatology, reassign their Medicare billing to Epiphany Dermatology Of Georgia, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Epiphany Dermatology Of Georgia, LLC hold CLIA laboratory certificates?
Yes. 5 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Epiphany Dermatology Of Georgia, LLC accept?
Health plans from Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama, Ambetter of North Carolina and Ambetter of Tennessee list Epiphany Dermatology Of Georgia, 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 Georgia, LLC was last updated on March 19, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 Georgia, Llc · NPI 1265544357
Dermatology organization in Fayetteville, Georgia. Organization record, active in the CMS NPPES registry since August 31, 2006.
## Identity
- **NPI:** 1265544357 (Entity type: Organization)
- **Enumerated:** August 31, 2006
- **Primary specialty:** Dermatology · taxonomy 207N00000X
- **Also known as:** Epiphany Dermatology (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Gheorghe Pusta, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 874 LANIER AVE W STE 270, Fayetteville, GA 30214-7617
- **Phone:** (770) 251-5111
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 13 clinicians (Dermatology) reassign Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 19, 2025
- **CLIA laboratory certificates:** 5 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1265544357) · Data from the CMS NPPES public registry.