Epiphany Dermatology – Dermatology Physician, NPI 1679521165
Dermatology Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Epiphany Dermatology
7300 RANCH ROAD 2222, BLDG 1, STE 200
AUSTIN, TX 787303255
Phone: (512) 628-0465
Type: Mailing
Rock Spring Drive, Bethesda, Montgomery County, Maryland, 20817, United States
BETHESDA, MD 208171154
Phone: (301) 530-8300
Type: Location
1300 BAXTER ST STE 170
CHARLOTTE, NC 282043808
Phone: (704) 413-3199
Type: Mailing
Fairview Road, Carmel Park, Charlotte, Mecklenburg County, North Carolina, 28226, United States
CHARLOTTE, NC 282103113
Phone: (980) 233-3220
Type: Mailing
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: 2025-05-15
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2026-05-31 (8 days ago).
Enrollment records
2
Earliest due date
2026-05-31
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040512000344 | O | Clinic/Group Practice | DC | 2026-05-31 |
| O20250515001269 | O | Clinic/Group Practice | MD | TBD |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
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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