Epiphany Dermatology of Arizona, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

EPIPHANY DERMATOLOGY OF ARIZONA, LLC

Practice address

7767 W Deer Valley Rd
Suite 140
Peoria, AZ 85382-2103

Phone

(623) 487-3003

Fax

(623) 487-0952

NPI assigned

Aug 19, 2006

Last updated

Dec 7, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Gheorghe Pusta

Title

Ceo

Phone

(512) 628-0465

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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 45

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jennifer Claire Aronica, M.D.

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1699160697

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Jessica Dixon

  • Physician Assistant
  • Cottonwood, AZ
  • NPI 1336872803
  Medicare reassignment Care Compare group NPD
• Keith J Haar, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1902852320
  Medicare reassignment Care Compare group NPD
• Aleksi Hendricks, MD

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1265060776
  Medicare reassignment Care Compare group NPD
• Dane Hill, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1992118434
  Medicare reassignment Care Compare group NPD
• Teresa D Hunt, PA-C

  • Physician Assistant
  • Phoenix, AZ
  • NPI 1518389857
  Medicare reassignment Care Compare group NPD
• Morgan James Mackey, D.O.

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1699087809
  Medicare reassignment Care Compare group NPD
• Angelo A Petropolis, MD

  • Dermatology Physician
  • Sierra Vista, AZ
  • NPI 1457391732
  Medicare reassignment Care Compare group NPD
• Jennifer Nashay Rorex, MD

  • Dermatology Physician
  • Peoria, AZ
  • NPI 1447875372
  Medicare reassignment Care Compare group NPD
• Alexander Nicholas Rose, MD

  • Dermatology Physician
  • Tucson, AZ
  • NPI 1376293761
  Medicare reassignment Care Compare group NPD
• Bridget Nicole Shaw, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Tucson, AZ
  • NPI 1285204719
  Medicare reassignment Care Compare group NPD
• Sarah Elizabeth Blair Smith, MD

  • Dermatology Physician
  • Scottsdale, AZ
  • NPI 1518661040
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701907200000",
    "number": "1457465858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7300 RANCH RD. 2222, BLDG 1, STE 200",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78730",
            "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": "7767 W DEER VALLEY RD",
            "address_2": "SUITE 140",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853822103",
            "telephone_number": "623-487-3003",
            "fax_number": "623-487-0952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EPIPHANY DERMATOLOGY OF ARIZONA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2023-12-07",
        "certification_date": "2023-12-07",
        "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",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Marie Englund, PHARMD
• Enkatsu Management (Pleasant Dentistry)
• Lorena Elizabeth Enriquez
• Envi PLLC
• Daniel Enzi, PRSS
• Erin Kate Epley, PHARM.D.
• Melissa Lucile Epley, RN IBCLC
• Levente Edward Erdos, MD
• Kendall Shannon Ereth, D.C.
• Elena C Erghelegiu

• Dermatology Physician in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Dermatology Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2023; 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.