Individual provider Active NPI

Olga Matatova, PA-C

  • Medical Physician Assistant
  • Scottsdale, AZ
National Provider Identifier
1992123046
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5648 Issued in AZ
Practice address
4432 N Miller Rd Ste 102
Scottsdale, AZ 85251-3697
Phone
(480) 945-0008
NPI assigned
Apr 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5648 AZ Primary

Addresses

Primary practice location

4432 N Miller Rd Ste 102
Scottsdale, AZ 85251-3697

Mailing address

10046 N Metro Pkwy W
115
Phoenix, AZ 85051-1437
Phone (602) 674-5515

Other practice location 1

9971 W Camelback Rd Ste 105
Phoenix, AZ 85037-5011
Phone (623) 872-0002

Other practice location 2

1855 E Guadalupe Rd Ste 112
Tempe, AZ 85283-3269
Phone (480) 839-8552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140828002544 AZ Practitioner - Physician Assistant 6305064536 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tempe Angic, LLCGroup PAC ID 0042708992, 4 clinicians
Scottsdale Medical Partners LLCGroup PAC ID 5193213007, 4 clinicians

Practice addresses (Care Compare)

1855 E Guadalupe Rd
Suite 112
Tempe, AZ 85283-3269

4432 N Miller Rd
Suite 102
Scottsdale, AZ 85251-3697
Phone (480) 306-7227

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5648AZMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Tempe Angic, LLC Physician Assistant CurrentSince Oct 9, 2025 Accepting new patients
Scottsdale Medical Partners LLC Physician Assistant CurrentSince Oct 9, 2025 Accepting new patients
Next Level Facility LLC PastSince Nov 12, 2023 Accepting new patients

Locations

4432 N Miller Rd
Ste 102
Scottsdale, AZ 85251
Phone (480) 306-7227

1855 E Guadalupe Rd
Ste 112
Tempe, AZ 85283
Phone (480) 306-7227

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748390400000",
    "number": "1992123046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10046 N METRO PKWY W",
            "address_2": "115",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850511437",
            "telephone_number": "602-674-5515",
            "fax_number": "602-674-3029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4432 N MILLER RD STE 102",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852513697",
            "telephone_number": "480-945-0008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9971 W Camelback Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850375011",
            "country_code": "US",
            "telephone_number": "623-872-0002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1855 E Guadalupe Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Tempe",
            "state": "AZ",
            "postal_code": "852833269",
            "country_code": "US",
            "telephone_number": "480-839-8552",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATATOVA",
        "first_name": "OLGA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-04",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "5648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.