EPIPHANY DERMATOLOGY OF KANSAS, LLC
NPI 1710444500
Dermatology in Overland Park, KS

NPI Status: Active since February 27, 2019

Contact Information

8505 COLLEGE BLVD
OVERLAND PARK, KS
ZIP 66210
Phone: (913) 541-3230

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  • Organization
  • Dermatology
  • Accepts Insurance
  • CLIA Number: 17D0677930
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 07-06-2025

About EPIPHANY DERMATOLOGY OF KANSAS, LLC

This page provides the complete NPI Profile along with additional information for Epiphany Dermatology Of Kansas, Llc, a provider established in Overland Park, Kansas operating as a Dermatology. The healthcare provider is registered in the NPI registry with number 1710444500 assigned on February 2019. The practitioner's primary taxonomy code is 207N00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Gheorghe Pusta (Executive Director)

NPI
1710444500
Provider Name
EPIPHANY DERMATOLOGY OF KANSAS, LLC
Entity Type
Organization
Location Address
8505 COLLEGE BLVD OVERLAND PARK, KS 66210
Location Phone
(913) 541-3230
Mailing Address
7300 RANCH RD. 2222, BLDG 1, STE 200 AUSTIN, TX 78730
Mailing Phone
(512) 628-0465
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-27-2019
Last Update Date
12-07-2023
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A dermatologist like Epiphany Dermatology Of Kansas, Llc 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.

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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:

  • Bronze 2 Advanced HSA: Aetna network + CVS Health Virtual Primary Care - EPO
  • Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - EPO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Bronze 4 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
  • Bronze S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Gold S: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - EPO
  • Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Silver 10 Advanced: Aetna network + $0 CVS Health Virtual Primary Care + Adult Dental + Vision - EPO
  • Silver 5 Advanced: Aetna network + $0 CVS Health Virtual Primary Care - EPO
  • Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - EPO
  • Anthem Bronze Pathway 6900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Bronze Pathway 9200 (+ Incentives) - EPO
  • Anthem Catastrophic Pathway 9200 (+ Incentives) - EPO
  • Anthem Gold Pathway 1500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Bronze Pathway 4900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Heart Healthy Silver Pathway 2900 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 5350 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • Anthem Silver Pathway 7250 ($0 Virtual PCP + $0 Select Drugs + Incentives) - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Value ($0 Virtual Urgent Care, $5 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Gold Standard (No Referrals) - EPO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO
  • UHC Silver Advantage+ ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - EPO
  • UHC Silver Standard (No Referrals) - EPO
  • UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - EPO

*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
EXECUTIVE DIRECTOR
Authorized Official Phone
(512) 628-0465

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
17D0677930
Facility Type
Physician Office
Certificate Effective Date
July 07, 2023
Certificate Expiration Date
July 06, 2025
Laboratory Director
MATTHEW S. DACUNHA
Certificate Type
Certificate of Compliance
Certificate Type Description
This CLIA certificate is issued to Epiphany Dermatology Of Kansas, Llc 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.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1710444500
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
272084850
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 7 + 2 + 0 + 8 + 4 + 8 + 5 + 0 + 24 = 60
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero.
0

The NPI number 1710444500 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following provider is registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1073397907 MADISON FADDIS DNP, FNP-C
Individual
Nurse Practitioner (Family)8505 COLLEGE BLVD
OVERLAND PARK, KS 66210
(913) 541-3230

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1710444500, enumerated in the NPI registry as an "organization" on February 27, 2019

The provider is located at 8505 College Blvd Overland Park, Ks 66210 and the phone number is (913) 541-3230

This medical organization specializes in Dermatology with taxonomy code 207N00000X

The provider might be accepting Accepts: Aetna CVS Health, Anthem Blue Cross and Blue. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

The provider's CLIA number is 17D0677930 for a "physician office" facility with a CLIA Certificate of Compliance. This CLIA certificate is issued 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..

This NPI record was last updated on February 27, 2019. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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