SAMUEL DEVICTOR (MD) – Facial Plastic Surgery Physician, NPI 1619301884
Facial Plastic Surgery Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
185 PLASTIC AND RECONSTRUCTIVE SURGERY in GA
Provider Addresses for SAMUEL DEVICTOR (MD)
1400 COLEMAN AVE
MACON, GA 312070001
Phone:
Type: Mailing
8994 E DESERT COVE AVE
SCOTTSDALE, AZ 852607901
Phone: (480) 551-2040
Type: Location
8994 E Desert Cove Ave
Scottsdale, AZ 852607901
Phone: (480) 551-2040
Type: Location
2521 STOCKTON BLVD STE 7200
SACRAMENTO, CA 958172207
Phone:
Type: Mailing
5310 HARVEST HILL RD STE 290
DALLAS, TX 752305826
Phone:
Type: Mailing
11130 N TATUM BLVD STE 100
PHOENIX, AZ 850281630
Phone: (602) 737-1361
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
Loading prescription activity...
Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $42.
Total Amount is formed as General ($42) + Research ($0) + Ownership ($0) = $42.
Last reported payment date: 2023-10-31 • Largest payer in this snapshot: Sun Pharmaceutical Industries Inc. ($25).
Total Amount
$42
General + Research + Ownership
Payments
2
Total payment records
General Amount
$42
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-31
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Sun Pharmaceutical Industries Inc. | $25 |
| Incyte Corporation | $17 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2023-04-19
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230419002820 | I | Plastic And Reconstructive Surgery | AZ | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 14040 | Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.0 sq cm or less | 31 | 29 | $0 |
| 13132 | Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm | 28 | 26 | $0 |
| 14060 | Repair of wound of eyelids, nose, ears, or lips by transferring skin, 10.0 sq cm or less | 25 | 24 | $0 |
| 14041 | Repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet by transferring skin, 10.1-30.0 sq cm | 15 | 14 | $0 |
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 14 | 12 | $0 |
Insurance plans in this area (ZIP 31207)
Loading plans...
Group practice members
| Name | Specialty | State |
|---|---|---|
| D E R M A T O L O G Y | AZ | |
| Dermatology, Pathology | AZ | |
| P A T H O L O G Y | AZ | |
| Physician Assistant | AZ | |
| D E R M A T O L O G Y | AZ | |
| D E R M A T O L O G Y | AZ | |
| D E R M A T O L O G Y | AZ | |
| D E R M A T O L O G Y | AZ | |
| - | AZ | |
| Physician Assistant | AZ |
Reviews
All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.
No reviews yet. Be the first to share your experience — your opinion helps families compare providers.