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SUPERNOVA CONSULTING LLC
NPI 1205486800
Plastic Surgery in Phoenix, AZ

Active since September 16, 2019
4550 E BELL RD STE 150, PHOENIX, AZ 85032(480) 576-4310 Get Directions Write a Review

NPPES record last updated: April 26, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 26, 2021, Sep 16, 2019 (2 updates tracked since 2019).

About Supernova Consulting Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUPERNOVA CONSULTING LLC (NPI 1205486800) is a healthcare organization registered as a plastic surgery in Phoenix, Arizona and active in the NPI registry since September 2019. The organization maintains a secondary practice location in Phoenix and lists Tim Matatov, Ceo, as its authorized official.

NPPES Registry Identity

NPI1205486800
Entity TypeOrganization
Primary Taxonomy208200000X
Legal Business NameSUPERNOVA CONSULTING LLC
Location Address4550 E BELL RD STE 150Phoenix, AZ 85032-9382
Mailing Address4550 E Bell Rd Ste 150Phoenix, AZ 85032-9382 · (480) 576-4310
Phone(480) 576-4310
Organization SubpartNo
Authorized OfficialTim MatatovCeo · (480) 576-4310
Enumeration DateSeptember 16, 2019
Last NPPES UpdateApril 26, 20212 updates tracked since enumeration
NPPES CertifiedApril 26, 2021
✔ NPI 1205486800 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPlastic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208200000X
Definition
A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well.
4550 E BELL RD STE 150, Phoenix, AZ 85032
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Secondary Practice Location 1

Location 110910 N Tatum Blvd Ste B100Phoenix, AZ 85028-3080 · Phone (480) 291-6895

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OMEGA SURGICAL PLLC
Plastic Surgery
4550 E BELL RD STE 150
PHOENIX, AZ 85032
Maricopa County (480) 576-4310
TIM MATATOV MD., PROFESSIONAL CORPORATION
Plastic Surgery
4550 E BELL RD STE 150
PHOENIX, AZ 85032
Maricopa County (480) 576-4310

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Supernova Consulting LLC's NPI number?

The NPI number for Supernova Consulting LLC is 1205486800. It was assigned to this organization in the NPPES registry on September 16, 2019.

Where is Supernova Consulting LLC located?

Supernova Consulting LLC is located at 4550 E Bell Rd Ste 150, Phoenix, AZ 85032. The listed phone number is (480) 576-4310.

What is Supernova Consulting LLC's specialty?

The primary specialty registered for this NPI is Plastic Surgery with taxonomy code 208200000X.

When was this NPI record last updated?

The NPPES record for Supernova Consulting LLC was last updated on April 26, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.