Epiphany Dermatology of Georgia, LLC
NPI 1265544357 · Dermatology Physician · Fayetteville, GA
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Epiphany Dermatology of Georgia, LLC is a Dermatology Physician organization in Fayetteville, GA (NPI 1265544357).
Provider details
- NPI number
- 1265544357
- Entity type
- Organization
- Primary specialty
- Dermatology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Gheorghe Pusta, Executive Director(512) 628-0465
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- MOHS-Micrographic Surgery Physician207ND0101X
Allopathic & Osteopathic Physicians
- Procedural Dermatology Physician207NS0135X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Epiphany Dermatology
Registry dates
- Enumerated
- 2006-08-31
- Last updated
- 2025-03-19
- Certified
- 2025-03-19
Frequently asked questions
- What is Epiphany Dermatology of Georgia, LLC's NPI number?
- Epiphany Dermatology of Georgia, LLC's National Provider Identifier (NPI) is 1265544357, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Epiphany Dermatology of Georgia, LLC?
- Epiphany Dermatology of Georgia, LLC is classified in the NPPES registry as Dermatology Physician (Allopathic & Osteopathic Physicians).
- Where is Epiphany Dermatology of Georgia, LLC located?
- Epiphany Dermatology of Georgia, LLC's practice location on file with NPPES is 874 Lanier Ave W Ste 270, Fayetteville, GA 30214-7617.
- What is Epiphany Dermatology of Georgia, LLC's phone number?
- The practice phone number listed in the NPPES registry for Epiphany Dermatology of Georgia, LLC is (770) 251-5111.
- Does Epiphany Dermatology of Georgia, LLC accept Medicare?
- Epiphany Dermatology of Georgia, LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Epiphany Dermatology of Georgia, LLC?
- The authorized official listed on Epiphany Dermatology of Georgia, LLC's NPPES record is Gheorghe Pusta, Executive Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Epiphany Dermatology of Georgia, LLC's NPI active?
- Yes — Epiphany Dermatology of Georgia, LLC's NPI (1265544357) is active in the NPPES registry as of the last update on 2025-03-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.