Samuel Devictor, MD

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

68902 Issued in AZ

Practice address

8994 E Desert Cove Ave
Scottsdale, AZ 85260-7901

Phone

(480) 551-2040

NPI assigned

Aug 23, 2013

Last updated

Feb 9, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Plastic and Reconstructive SurgeryAlso: Dermatology

Education

Mercer University School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southwest Skin Specialists LLCGroup PAC ID 9739079864, 51 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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

• Southwest Skin Specialists LLC

  • Dermatology Physician
  • Phoenix, AZ
  • NPI 1174521926
  Medicare reassignment Care Compare group NPD
• Southwest Skin Specialists, LLC

  dba Southwest Skin Specialists, LTD /

  • Clinical Medical Laboratory
  • Scottsdale, AZ
  • NPI 1609185347
  NPD
• Mercer University School of Medicine

  • Student in an Organized Health Care Education/Training Program
  • Macon, GA
  • NPI 1659705986
  NPD (past)

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

{
    "created_epoch": "1377216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770595200000",
    "number": "1619301884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8994 E DESERT COVE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607901",
            "telephone_number": "480-551-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8994 E DESERT COVE AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852607901",
            "telephone_number": "480-551-2040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8994 E Desert Cove Ave",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852607901",
            "country_code": "US",
            "telephone_number": "480-551-2040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEVICTOR",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-23",
        "last_updated": "2026-02-09",
        "certification_date": "2026-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "AZ",
            "license": "68902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dustin Lee Deutsch, OD
• Developmental & Educational Psychological Services
• Lauren Kathleen Dever, MS OTR L
• Devereux Foundation (Devereux Arizona - Respite E3)
• Jessie Deverna, LPC
• Devine Therapy, LLC
• Larry Devine, D.C.
• Loretta Devine, RN
• Christina Jean Devita, LPC
• Devito Plastic Surgery LLC

• Facial Plastic Surgery Physician in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Facial Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.