Samuel Devictor, - Medicare Plastic And Reconstructive Surgery in Phoenix, AZ

Samuel Devictor, is a medicare enrolled "Otolaryngology - Facial Plastic Surgery" physician in Phoenix, Arizona. He went to Mercer University School Of Medicine and graduated in 2017 and has 7 years of diverse experience with area of expertise as Plastic And Reconstructive Surgery. He is a member of the group practice Southwest Skin Specialists Llc and his current practice location is 11130 N Tatum Blvd Ste 100, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 737-1361.

Samuel Devictor is licensed to practice in Arizona (license number 68902) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1619301884.

Contact Information

Samuel Devictor,
11130 N Tatum Blvd Ste 100,
Phoenix, AZ 85028-1630
(602) 737-1361
Not Available

Map and Direction




Physician's Profile

Full NameSamuel Devictor
GenderMale
SpecialityPlastic And Reconstructive Surgery
Experience7 Years
Location11130 N Tatum Blvd Ste 100, Phoenix, Arizona
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samuel Devictor attended and graduated from Mercer University School Of Medicine in 2017
  NPI Data:
  • NPI Number: 1619301884
  • Provider Enumeration Date: 08/23/2013
  • Last Update Date: 08/24/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 5597004010
  • Enrollment ID: I20230419002820

Medical Identifiers

Medical identifiers for Samuel Devictor such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619301884NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207YS0123XOtolaryngology - Facial Plastic Surgery 68902 (Arizona)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Southwest Skin Specialists Llc973907986447

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Devictor allows following entities to bill medicare on his behalf.
Entity NameSouthwest Skin Specialists Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1174521926
PECOS PAC ID: 9739079864
Enrollment ID: O20040319001063

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Devictor is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Samuel Devictor,
5310 Harvest Hill Rd Ste 290,
Dallas, TX 75230-5826

Ph: () -
Samuel Devictor,
11130 N Tatum Blvd Ste 100,
Phoenix, AZ 85028-1630

Ph: (602) 737-1361

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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