EPIPHANY DERMATOLOGY OF NEW JERSEY LLC
NPI 1720931801
Dermatology in Bridgewater, NJ

Active since February 18, 2026CLIA Certified · 3 labs
1200 ROUTE 22 E., BRIDGEWATER, NJ 08807(973) 267-0300 Get Directions Write a Review

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

About Epiphany Dermatology Of New Jersey Llc NPPES

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

EPIPHANY DERMATOLOGY OF NEW JERSEY LLC (NPI 1720931801) is a healthcare organization registered as a dermatology in Bridgewater, New Jersey and active in the NPI registry since February 2026. The organization holds 3 active CLIA laboratory certificates, maintains 2 additional practice locations, and lists Gheorghe Pusta, Secretary, as its authorized official.

NPPES Registry Identity

NPI1720931801
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF NEW JERSEY LLC
Location Address1200 ROUTE 22 E.Bridgewater, NJ 08807-2943
Mailing Address7300 Ranch Road 2222, Bldg 1, Ste 200Austin, TX 78730-3255 · (512) 628-0465 · Fax (512) 233-2711
Organization SubpartNo
Authorized OfficialGheorghe PustaSecretary · (512) 628-0465
Enumeration DateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1720931801 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.
1200 ROUTE 22 E., Bridgewater, NJ 08807

Secondary Practice Locations 2

Location 1182 South St Ste 1Morristown, NJ 07960-5350 · Phone (973) 267-0300
Location 2400 Valley Rd Ste 100Mount Arlington, NJ 07856-2316 · Phone (973) 267-0300

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

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 New Jersey Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

9

Medicare enrollment records show 9 clinicians reassign Medicare billing to Epiphany Dermatology Of New Jersey LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (9)

Dermatology
NPI 1063678944
1200 ROUTE 22 EAST
Bridgewater, NJ 08807
(973) 267-0300
✔ PECOS✔ Accepts MedicareSame address
Nurse Practitioner
NPI 1205015245
182 SOUTH ST SUITE 1
Morristown, NJ 07960
(973) 267-0300
✔ PECOS✔ Accepts Medicare16 mi
Dermatology
NPI 1396940334
182 SOUTH ST SUITE 1
Morristown, NJ 07960
(973) 267-0577
✔ PECOS✔ Accepts Medicare16 mi
Nurse Practitioner
NPI 1487773164
182 SOUTH ST STE 1
Morristown, NJ 07960
(973) 267-0300
✔ PECOS✔ Accepts Medicare16 mi
Dermatology
NPI 1235224759
182 SOUTH ST SUITE 1
Morristown, NJ 07960
(973) 267-0300
✔ PECOS✔ Accepts Medicare16 mi
Nurse Practitioner
NPI 1255159489
182 SOUTH ST
Morristown, NJ 07960
(973) 267-0300
✔ PECOS✔ Accepts Medicare16 mi
Dermatology
NPI 1275629404
182 SOUTH STREET SUITE 1
Morristown, NJ 07960
(973) 267-0300
✔ PECOS✔ Accepts Medicare16 mi
Dermatology
NPI 1598343360
UI HEALTH, GRADUATE MEDICAL EDUCATION OFFICE 820 SOUTH WOOD STREET. SUITE 100, MC 675
Chicago, IL 60612
(312) 996-2933
✔ PECOS✔ Accepts Medicare688 mi
Dermatology
NPI 1861057671
12605 E 16TH AVE
Aurora, CO 80045
(720) 848-0000
✔ PECOS✔ Accepts Medicare1,595 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 3

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 Waiver 31D2344756

Epiphany Dermatology Of New Jersey, LLC · Mount Arlington, NJ
Active · expires May 28, 2028
CLIA Number31D2344756
Laboratory TypePhysician Office
Certificate Effective DateMay 29, 2026
Certificate Expiration DateMay 28, 2028
Laboratory DirectorLauren Cooper
Laboratory Phone(973) 267-0300
Laboratory LocationEpiphany Dermatology Of New Jersey, LLC400 Valley Road Suite 100, Mount Arlington, NJ 07856
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 31D2344610

Epiphany Dermatology Of New Jersey, LLC · Bridgewater, NJ
Active · expires May 26, 2028
CLIA Number31D2344610
Laboratory TypePhysician Office
Certificate Effective DateMay 27, 2026
Certificate Expiration DateMay 26, 2028
Laboratory DirectorLauren Cooper
Laboratory Phone(973) 267-0300
Laboratory LocationEpiphany Dermatology Of New Jersey, LLC1200 Route 22 East Suite 300, Bridgewater, NJ 08807
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Compliance 31D0685177

Epiphany Dermatology Of New Jersey, LLC · Morristown, NJ
Active · expires Feb 17, 2027
CLIA Number31D0685177
Laboratory TypePhysician Office
Certificate Effective DateFebruary 18, 2025
Certificate Expiration DateFebruary 17, 2027
Laboratory DirectorKristyna H. Lee
Laboratory Phone(973) 267-0300
Laboratory LocationEpiphany Dermatology Of New Jersey, LLC182 South Street Suite 1, Morristown, NJ 07960
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 New Jersey LLC's NPI number?

The NPI number for Epiphany Dermatology Of New Jersey LLC is 1720931801. It was assigned to this organization in the NPPES registry on February 18, 2026.

Where is Epiphany Dermatology Of New Jersey LLC located?

Epiphany Dermatology Of New Jersey LLC is located at 1200 Route 22 E., Bridgewater, NJ 08807. The listed phone number is (973) 267-0300.

What is Epiphany Dermatology Of New Jersey LLC's specialty?

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

Is Epiphany Dermatology Of New Jersey LLC enrolled in Medicare?

Yes. Epiphany Dermatology Of New Jersey LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Epiphany Dermatology Of New Jersey LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 9 clinicians in 2 Medicare specialties reassign their Medicare billing to Epiphany Dermatology Of New Jersey 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 (6) and Nurse Practitioner (3). Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Epiphany Dermatology Of New Jersey LLC hold CLIA laboratory certificates?

Yes. 3 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.

When was this NPI record last updated?

The NPPES record for Epiphany Dermatology Of New Jersey LLC was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.