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EPIPHANY DERMATOLOGY OF KANSAS, LLC
NPI 1710444500
Dermatology in Overland Park, KS

Active since February 27, 2019CLIA 17D0677930 · Certificate of Compliance
8505 COLLEGE BLVD, OVERLAND PARK, KS 66210(913) 541-3230 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 7, 2023, Feb 27, 2019 (2 updates tracked since 2019).

About Epiphany Dermatology Of Kansas, Llc NPPES

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

EPIPHANY DERMATOLOGY OF KANSAS, LLC (NPI 1710444500) is a healthcare organization registered as a dermatology in Overland Park, Kansas and active in the NPI registry since February 2019. The organization holds a CLIA Certificate of Compliance certificate valid through July 6, 2027 and lists Gheorghe Pusta, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1710444500
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF KANSAS, LLC
Location Address8505 COLLEGE BLVDOverland Park, KS 66210-1836
Mailing Address7300 Ranch Rd. 2222, Bldg 1, Ste 200Austin, TX 78730 · (512) 628-0465
Phone(913) 541-3230
Organization SubpartNo
Authorized OfficialGheorghe PustaExecutive Director · (512) 628-0465
Enumeration DateFebruary 27, 2019
Last NPPES UpdateDecember 7, 20232 updates tracked since enumeration
NPPES CertifiedDecember 7, 2023
✔ NPI 1710444500 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.
8505 COLLEGE BLVD, Overland Park, KS 66210
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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 Anthem Blue Cross and Blue Shield.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 Kansas, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

11

Medicare enrollment records show 11 clinicians reassign Medicare billing to Epiphany Dermatology Of Kansas, LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 5 within 10 miles. They are listed nearest first.

Clinicians by Medicare Specialty 2

Dermatology8
Nurse Practitioner3

Clinicians, nearest first (11)

Madison Faddis, DNP, FNP-C
Nurse Practitioner
NPI 1073397907
8505 COLLEGE BLVD
Overland Park, KS 66210
(913) 541-3230
✔ PECOS✔ Accepts MedicareSame address
Mark Mccune, M.D.
Dermatology
NPI 1871607267
10600 QUIVIRA RD SUITE 430
Overland Park, KS 66215
(913) 541-3230
✔ PECOS✔ Accepts Medicare2.4 mi
Brenda Lane, ARNP
Nurse Practitioner
NPI 1013010560
10600 QUIVIRA ROAD SUITE 430
Overland Park, KS 66215
(913) 541-3230
✔ PECOS✔ Accepts Medicare2.4 mi
Amanda Stallings, DO
Dermatology
NPI 1134862188
5405 W 151ST ST
Leawood, KS 66224
(913) 901-5001
✔ PECOS5.4 mi
Margaret Costello, RN, ARNP
Nurse Practitioner
NPI 1245566629
6420 PROSPECT AVE SUITE T407
Kansas City, MO 64132
(816) 333-5424
✔ PECOS✔ Accepts Medicare8.9 mi
Daniel Christiansen, MD
Dermatology
NPI 1265695589
6800 HILLTOP RD STE 102
Shawnee, KS 66226
(913) 901-5001
✔ PECOS✔ Accepts Medicare10 mi
Julie Green, MD
Dermatology
NPI 1184935256
3265 NE RALPH POWELL RD
Lees Summit, MO 64064
(913) 451-7546
✔ PECOS✔ Accepts Medicare18 mi
Christine Ku, D.O.
Dermatology
NPI 1679974984
201 NW R D MIZE RD
Blue Springs, MO 64014
(816) 655-5426
✔ PECOS✔ Accepts Medicare24 mi
Elizabeth Spenceri, MD
Dermatology
NPI 1588665509
1240 E INDEPENDENCE ST STE 100
Springfield, MO 65804
(417) 900-3407
✔ PECOS✔ Accepts Medicare145 mi
Matthew Dacunha, MD
Dermatology
NPI 1659833622
3024 BURNET AVE
Cincinnati, OH 45219
(513) 221-2828
✔ PECOS✔ Accepts Medicare548 mi
Whitney Call, D.O.
Dermatology
NPI 1740522515
2904 W HORIZON RIDGE PKWY STE 100
Henderson, NV 89052
(702) 906-0060
✔ PECOS✔ Accepts Medicare1,139 mi

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 of Compliance 17D0677930

Epiphany Dermatology Of Kansas, LLC · Overland Park, KS
Active · expires Jul 6, 2027
CLIA Number17D0677930
Laboratory TypePhysician Office
Certificate Effective DateJuly 7, 2025
Certificate Expiration DateJuly 6, 2027
Laboratory DirectorMatthew S. Dacunha
Laboratory Phone(913) 541-3230
Laboratory LocationEpiphany Dermatology Of Kansas, LLC8505 College Blvd, Overland Park, KS 66210
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

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 Kansas, LLC's NPI number?

The NPI number for Epiphany Dermatology Of Kansas, LLC is 1710444500. It was assigned to this organization in the NPPES registry on February 27, 2019.

Where is Epiphany Dermatology Of Kansas, LLC located?

Epiphany Dermatology Of Kansas, LLC is located at 8505 College Blvd, Overland Park, KS 66210. The listed phone number is (913) 541-3230.

What is Epiphany Dermatology Of Kansas, LLC's specialty?

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

Is Epiphany Dermatology Of Kansas, LLC enrolled in Medicare?

Yes. Epiphany Dermatology Of Kansas, LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Epiphany Dermatology Of Kansas, LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 11 clinicians in 2 Medicare specialties reassign their Medicare billing to Epiphany Dermatology Of Kansas, 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. The largest specialties are Dermatology (8) and Nurse Practitioner (3). Of these, 1 practice at this address and 5 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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

Yes. A Certificate of Compliance (number 17D0677930) is associated with this NPI, valid through July 6, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Epiphany Dermatology Of Kansas, LLC accept?

Health plans from Anthem Blue Cross and Blue Shield list Epiphany Dermatology Of Kansas, 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 Kansas, LLC 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.