EPIPHANY DERMATOLOGY OF MONTANA, PLLC
NPI 1902455074
Dermatology in Butte, MT

Active since September 10, 2019CLIA 27D0893570 · Certificate of Compliance
24 E BROADWAY ST, BUTTE, MT 59701(406) 723-7272(406) 723-3328 Get Directions Write a Review

NPPES record last updated: December 7, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Dec 7, 2023, Feb 10, 2020, Sep 10, 2019 (3 updates tracked since 2019).

  • Organization
  • Dermatology
  • Accepts Insurance
  • CLIA Number: 27D0893570
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 02-24-2027

About EPIPHANY DERMATOLOGY OF MONTANA, PLLC

This page provides the complete NPI Profile along with additional information for Epiphany Dermatology Of Montana, Pllc, a provider established in Butte, Montana operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1902455074 assigned on September 2019. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 3 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Gheorghe Pusta (Director/managing Employee)

NPI
1902455074 Verify this NPI
Provider Name
EPIPHANY DERMATOLOGY OF MONTANA, PLLC
Entity Type
Organization
Location Address
24 E BROADWAY ST BUTTE, MT 59701
Location Phone
(406) 723-7272
Location Fax
(406) 723-3328
Mailing Address
7300 RANCH RD. 2222, BLDG 1, STE 200 AUSTIN, TX 78730
Mailing Phone
(512) 628-0465
Mailing Fax
(512) 233-2711
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
09-10-2019
Last Update Date
12-07-2023
Code Navigator

A dermatologist like Epiphany Dermatology Of Montana, Pllc is a medical specialty involving the management of skin conditions and diseases. Dermatologists diagnose some sexually transmitted diseases, warts, cancer, acne, dermatitis and may offer cosmetic treatments, and therapies that reduce age spots and wrinkles.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dermatology

Taxonomy Code
207N00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Preferred Bronze PPO? 201 - PPO
  • Blue Preferred Bronze PPO? 202 - PPO
  • Blue Preferred Bronze PPO? Standard - PPO
  • Blue Preferred Gold PPO? 204 - PPO
  • Blue Preferred Gold PPO? 901 - PPO
  • Blue Preferred Gold PPO? Standard - PPO
  • Blue Preferred Security PPO? 200 - PPO
  • Blue Preferred Silver PPO? 203 - PPO
  • Blue Preferred Silver PPO? 308 - PPO
  • Blue Preferred Silver PPO? Standard - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

GHEORGHE PUSTA

Authorized Official Title
DIRECTOR/MANAGING EMPLOYEE
Authorized Official Phone
(512) 960-5760

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
27D0893570
Facility Type
Physician Office
Certificate Effective Date
February 25, 2025
Certificate Expiration Date
February 24, 2027
Laboratory Director
DR. ALYSON A. THEDE
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Epiphany Dermatology Of Montana, Pllc after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements. This type of certificate is issued to laboratories that perform nonwaived (moderate and/or high complexity) testing.

Reviews for EPIPHANY DERMATOLOGY OF MONTANA, PLLC

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Social Worker (Clinical)
24 E BROADWAY ST
BUTTE, MT 59701
Physician Assistant
24 E BROADWAY ST
BUTTE, MT 59701
Dermatology
24 E BROADWAY ST
BUTTE, MT 59701

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1902455074, enumerated as an "organization" on September 10, 2019.

The provider is located at 24 E BROADWAY ST BUTTE, MT 59701 and the phone number is (406) 723-7272.

Dermatology with taxonomy code 207N00000X.

The provider might be accepting Accepts: Blue Cross and Blue Shield of Montana. Please consult your insurance carrier or call the provider to verify.