Epiphany Dermatology of Nevada - Hatch, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

EPIPHANY DERMATOLOGY OF NEVADA - HATCH, PLLC

Practice address

2904 W Horizon Ridge Pkwy Ste 100
Henderson, NV 89052-5016

Phone

(702) 906-0060

Fax

(702) 906-0072

NPI assigned

Apr 21, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gheorghe Pusta

Title

Ceo

Phone

(512) 628-0465

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Whitney L. Call, D.O.

  • MOHS-Micrographic Surgery Physician
  • Henderson, NV
  • NPI 1740522515

  Dermatology

  Medicare reassignment Care Compare group NPD
• Yizhen Elizabeth Martin, MD

  • Dermatology Physician
  • Nellis AFB, NV
  • NPI 1285174201
  Medicare reassignment Care Compare group NPD
• Janice Ke Jiang, MD

  • Dermatology Physician
  • Henderson, NV
  • NPI 1457988818
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1437846169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH ROAD 2222 STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787303204",
            "telephone_number": "512-628-0465",
            "fax_number": "512-628-0468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2904 W HORIZON RIDGE PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525016",
            "telephone_number": "702-906-0060",
            "fax_number": "702-906-0072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY DERMATOLOGY OF NEVADA - HATCH, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-21",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "PUSTA",
        "authorized_official_first_name": "GHEORGHE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "512-628-0465"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shimera Enis
• Barbara Ennis
• Jayden Trevon Ennis
• Terence Dustin M. Enriquez, DPT
• Jennifer Enterline
• Percelyn Episioco
• Tracy L. Epps
• Dawn Anne Epter, RPA-C
• Equal Housing Opportunity Inc
• Equality Project (Henderson Equality Center)

• Dermatology Physician in Henderson, NV
• Providers in Henderson, NV by specialty
• Dermatology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.