Supernova Consulting LLC
NPI 1205486800 · Plastic Surgery Physician · Phoenix, AZ
Supernova Consulting LLC is a Plastic Surgery Physician organization in Phoenix, AZ (NPI 1205486800).
Provider details
- NPI number
- 1205486800
- Entity type
- Organization
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Tim Matatov, Ceo(480) 576-4310
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
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
Additional practice locations (1)
- 10910 N Tatum Blvd Ste B100Phoenix, AZ 85028-3080Phone: (480) 291-6895
Registry dates
- Enumerated
- 2019-09-16
- Last updated
- 2021-04-26
- Certified
- 2021-04-26
Frequently asked questions
- What is Supernova Consulting LLC's NPI number?
- Supernova Consulting LLC's National Provider Identifier (NPI) is 1205486800, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Supernova Consulting LLC?
- Supernova Consulting LLC is classified in the NPPES registry as Plastic Surgery Physician (Allopathic & Osteopathic Physicians).
- Where is Supernova Consulting LLC located?
- Supernova Consulting LLC's practice location on file with NPPES is 4550 E Bell Rd Ste 150, Phoenix, AZ 85032-9382.
- What is Supernova Consulting LLC's phone number?
- The practice phone number listed in the NPPES registry for Supernova Consulting LLC is (480) 576-4310.
- Who is the authorized official for Supernova Consulting LLC?
- The authorized official listed on Supernova Consulting LLC's NPPES record is Tim Matatov, Ceo. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Supernova Consulting LLC's NPI active?
- Yes — Supernova Consulting LLC's NPI (1205486800) is active in the NPPES registry as of the last update on 2021-04-26.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.