EPIPHANY DERMATOLOGY OF NEW MEXICO, LLC
NPI 1447615760
Dermatology in Albuquerque, NM

Active since December 31, 2015CLIA 32D2123056 · Certificate of Compliance
5600 EUBANK BLVD NE, STE 110, ALBUQUERQUE, NM 87111(512) 628-0465(512) 628-0468 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Dec 7, 2023, Oct 10, 2016, Jan 15, 2016 and 1 more (4 updates tracked since 2015).

About Epiphany Dermatology Of New Mexico, Llc NPPES

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

EPIPHANY DERMATOLOGY OF NEW MEXICO, LLC (NPI 1447615760) is a healthcare organization registered as a dermatology in Albuquerque, New Mexico and active in the NPI registry since December 2015. The organization holds a CLIA Certificate of Compliance certificate valid through September 24, 2027 and lists Gheorghe Pusta, Manager, as its authorized official.

NPPES Registry Identity

NPI1447615760
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF NEW MEXICO, LLC
Location Address5600 EUBANK BLVD NE, STE 110Albuquerque, NM 87111-1519
Mailing Address7300 Ranch Rd. 2222, Bldg 1, Ste 200Austin, TX 78730-3255 · (512) 628-0465 · Fax (512) 628-0468
Fax(512) 628-0468
Organization SubpartNo
Authorized OfficialGheorghe PustaManager · (512) 628-0465
Enumeration DateDecember 31, 2015
Last NPPES UpdateDecember 7, 20234 updates tracked since enumeration
NPPES CertifiedDecember 7, 2023
NPI 1447615760 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License Licensed in NM · 88-97
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.

5600 EUBANK BLVD NE, Albuquerque, NM 87111

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 32D2123056

Epiphany Dermatology Of New Mexico, LLC · Albuquerque, NM
Active · expires Sep 24, 2027
CLIA Number32D2123056
Laboratory TypePhysician Office
Certificate Effective DateSeptember 25, 2025
Certificate Expiration DateSeptember 24, 2027
Laboratory DirectorDr. Ethan Levin
Laboratory Phone(505) 880-1920
Laboratory LocationEpiphany Dermatology Of New Mexico, LLC5600 Eubank Bld NE, # 110, Albuquerque, NM 87111
CLIA data matches this NPI record on: 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.

Hospitalist
5600 EUBANK BLVD NE
ALBUQUERQUE, NM 87111
Social Worker
5600 EUBANK BLVD NE, #160
ALBUQUERQUE, NM 87111

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 New Mexico, LLC's NPI number?

The NPI number for Epiphany Dermatology Of New Mexico, LLC is 1447615760. It was assigned to this organization in the NPPES registry on December 31, 2015.

Where is Epiphany Dermatology Of New Mexico, LLC located?

Epiphany Dermatology Of New Mexico, LLC is located at 5600 Eubank Blvd NE Ste 110, Albuquerque, NM 87111. The listed phone number is (512) 628-0465.

What is Epiphany Dermatology Of New Mexico, LLC's specialty?

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

Does Epiphany Dermatology Of New Mexico, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 32D2123056) is associated with this NPI, valid through September 24, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Epiphany Dermatology Of New Mexico, LLC accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Superior HealthPlan, Ambetter of Oklahoma and WellPoint list Epiphany Dermatology Of New Mexico, 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 New Mexico, LLC was last updated on December 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.