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EPIPHANY DERMATOLOGY OF OKLAHOMA, LLC
NPI 1801320106
Dermatology in Tulsa, OK

Active since April 13, 2017CLIA 37D2137233 · Certificate of Compliance
10115 E 80TH ST STE A, TULSA, OK 74133(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: August 09, 2026.

Record update history: Dec 7, 2023, Apr 13, 2017 (2 updates tracked since 2017).

About Epiphany Dermatology Of Oklahoma, Llc NPPES

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

EPIPHANY DERMATOLOGY OF OKLAHOMA, LLC (NPI 1801320106) is a healthcare organization registered as a dermatology in Tulsa, Oklahoma and active in the NPI registry since April 2017. The organization holds a CLIA Certificate of Compliance certificate valid through March 28, 2028 and lists Gheorghe Pusta, Ceo, as its authorized official.

NPPES Registry Identity

NPI1801320106
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameEPIPHANY DERMATOLOGY OF OKLAHOMA, LLC
Location Address10115 E 80TH ST STE ATulsa, OK 74133-3421
Mailing Address7300 Ranch Rd. 2222, Bldg 1, Ste 200, Suite 200Austin, TX 78730 · (512) 628-0465
Phone(512) 628-0465
Fax(512) 628-0468
Organization SubpartNo
Authorized OfficialGheorghe PustaCeo · (512) 628-0465
Enumeration DateApril 13, 2017
Last NPPES UpdateDecember 7, 20232 updates tracked since enumeration
NPPES CertifiedDecember 7, 2023
✔ NPI 1801320106 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.
10115 E 80TH ST STE A, Tulsa, OK 74133
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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 Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.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 37D2137233

Epiphany Dermatology Of Oklahoma, LLC · Tulsa, OK
Active · expires Mar 28, 2028
CLIA Number37D2137233
Laboratory TypePhysician Office
Certificate Effective DateMarch 29, 2026
Certificate Expiration DateMarch 28, 2028
Laboratory DirectorCory B. Maughan
Laboratory Phone(918) 994-4400
Laboratory LocationEpiphany Dermatology Of Oklahoma, LLC10115 E 80th St, Ste A, Tulsa, OK 74133
CLIA data matches this NPI record on: Address 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

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

GRANT MICHAEL DIETZ PA-C
Physician Assistant
10115 E 80TH ST STE A
TULSA, OK 74133
Tulsa County (918) 994-4400

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 Oklahoma, LLC's NPI number?

The NPI number for Epiphany Dermatology Of Oklahoma, LLC is 1801320106. It was assigned to this organization in the NPPES registry on April 13, 2017.

Where is Epiphany Dermatology Of Oklahoma, LLC located?

Epiphany Dermatology Of Oklahoma, LLC is located at 10115 E 80th St Ste A, Tulsa, OK 74133. The listed phone number is (512) 628-0465.

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

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

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

Yes. A Certificate of Compliance (number 37D2137233) is associated with this NPI, valid through March 28, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Epiphany Dermatology Of Oklahoma, LLC accept?

Health plans from Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 1 other insurer list Epiphany Dermatology Of Oklahoma, 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 Oklahoma, 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.