EPIPHANY DERMATOLOGY PA – Dermatology Physician, NPI 1043615263

EPIPHANY DERMATOLOGY PA is a healthcare provider. based in Austin, Texas. specializing in Dermatology Physician. The organization holds a License No. Q1815 (TX). The NPI Number for EPIPHANY DERMATOLOGY PA is 1043615263

Main info

Organization
Name
EPIPHANY DERMATOLOGY PA
NPI
1043615263
Phone
(512) 628-0465
Address
6601 VAUGHT RANCH RD STE 200
Authorized Official
MR. GHEORGHE PUSTA CEO
Enumeration Date
30 October 2014
Last Update Date
21 July 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience56
Completeness75
Years active:11State licenses:1Digital endpointsOther names

Provider Addresses for EPIPHANY DERMATOLOGY PA

  • 6601 VAUGHT RANCH RD STE 200

    AUSTIN, TX 787302309

    Phone: (512) 628-0465

    Fax: (512) 628-0468

    Type: Mailing

  • 7300 RANCH ROAD 2222, BLDG 1, STE 200

    AUSTIN, TX 787303255

    Phone: (512) 628-0465

    Fax: (512) 628-0468

    Type: Mailing

  • 7106 SANGER AVENUE

    WACO, TX 767123928

    Phone: (254) 537-1265

    Fax: (254) 537-1310

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20150126001498OClinic/Group PracticeTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78730)

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Reviews

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Frequently asked questions

Can I cross-check EPIPHANY DERMATOLOGY PA using NPI 1043615263?
NPI 1043615263 belongs to EPIPHANY DERMATOLOGY PA; compare other details if you need extra assurance.
Is EPIPHANY DERMATOLOGY PA shown as active in public data?
Registry records indicate EPIPHANY DERMATOLOGY PA maintains an active NPI.
What area of care is associated with EPIPHANY DERMATOLOGY PA?
EPIPHANY DERMATOLOGY PA's record emphasizes Dermatology Physician. Clinical services aligned with this taxonomy classification.
Is EPIPHANY DERMATOLOGY PA located near Austin?
EPIPHANY DERMATOLOGY PA currently maps to Austin, Texas in this extract.
What does 3 location(s) imply?
3 practice locations appear in the available data.

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