Supernova Consulting LLC
NPI 1205486800ActiveOrganization· Plastic Surgery· Phoenix, AZ
Plastic Surgery in Phoenix, Arizona, registered in NPPES in September 2019. The authorized official on file is Tim Matatov, MD, Ceo.
Overview
| NPI | 1205486800 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 16, 2019 |
| Last updated in NPPES | Apr 26, 2021 |
| Certified by provider | Apr 26, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Plastic Surgery Primary | 208200000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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