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



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

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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

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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

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Otolaryngology Doctors in Phoenix, AZ

Dr. Shawn Michael Stevens, M.D.
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 2910 N 3rd Ave # 330, Phoenix, AZ 85013
Phone: 602-406-8811    Fax: 602-406-8810
Charles R Orozco, MD
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 4250 E Camelback, Suite K-250, Phoenix, AZ 85018
Phone: 602-253-9026    Fax: 602-252-6391
John David Macias, MD
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 1515 N 9th St, Suite B, Phoenix, AZ 85006
Phone: 602-257-4228    Fax: 602-252-6416
Dr. Michael L Hinni, M.D.
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 5779 E Mayo Blvd, Phoenix, AZ 85054
Phone: 480-301-8000    
Randy Oppenheimer, MD
Otolaryngology
Medicare: Medicare Enrolled
Practice Location: 2601 E Roosevelt St, Department Of Surgery, Phoenix, AZ 85008
Phone: 602-344-5608    Fax: 602-344-1299
Austin N Dehart, MD
Otolaryngology
Medicare: Medicare Enrolled
Practice Location: 1920 E Cambridge Ave Ste 201, Phoenix, AZ 85006
Phone: 602-933-3277    Fax: 602-933-4326
Griffin Santarelli, MD
Otolaryngology
Medicare: Accepting Medicare Assignments
Practice Location: 2910 N 3rd Ave # 330, Phoenix, AZ 85013
Phone: 602-406-8811    Fax: 602-406-8810

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