Epiphany Dermatology PA
NPI 1043615263ActiveOrganization· Dermatology· Waco, TX
Dermatology in Waco, Texas, registered in NPPES in October 2014. The authorized official on file is Gheorghe Pusta, Ceo. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1043615263 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 30, 2014 |
| Last updated in NPPES | Jul 21, 2023 |
| Certified by provider | Jul 21, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dermatology Primary | 207N00000X | Q1815 | TX |
| Dermatology, MOHS-Micrographic Surgery | 207ND0101X | Q1815 | TX |
| Clinic/Center, Radiology | 261QR0200X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (TX) |
|---|
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