NPIMap

Organization Active NPI

Tim Matatov MD., Professional Corporation

  • Plastic Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1841646247
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
52217 Issued in AZ
Legal business name
TIM MATATOV MD., PROFESSIONAL CORPORATION
Practice address
4550 E Bell Rd Ste 150
Phoenix, AZ 85032-9382
Phone
(480) 576-4310
NPI assigned
May 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Authorized official

Name
Dr. Tim Matatov, M.D.
Title
Director
Phone
(480) 576-4310

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 52217 AZ Primary

Addresses

Primary practice location

4550 E Bell Rd Ste 150
Phoenix, AZ 85032-9382

Mailing address

4550 E Bell Rd Ste 150
Phoenix, AZ 85032-9382
Phone (480) 576-4310

Other practice location 1

10910 N Tatum Blvd Ste 100
Phoenix, AZ 85028-3080
Phone (480) 291-6895

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address drmatatov@swba-az.com Direct

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619395200000",
    "number": "1841646247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329382",
            "telephone_number": "480-576-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD STE 150",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329382",
            "telephone_number": "480-576-4310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10910 N Tatum Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850283080",
            "country_code": "US",
            "telephone_number": "480-291-6895",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "TIM MATATOV MD., PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A",
        "authorized_official_last_name": "MATATOV",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "480-576-4310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "52217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drmatatov@swba-az.com",
            "affiliation": "N",
            "endpointDescription": "HIPPA Compliant Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4550 E Bell Rd Ste 150",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "850329382",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.