Samantha S. Fukutomi, MD, MPH

Primary specialty

Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X

License

13312645-1205 Issued in UT

Practice address

30 N 1900 E RM 2B200
Salt Lake City, UT 84132-0002

Phone

(801) 581-2121

NPI assigned

Mar 21, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Samantha Kodama Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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

Merit-based Incentive Payment System (MIPS)

Final score

89.77 of 100Reported as group

Quality

91.47

Promoting interoperability

100

Improvement activities

40

Cost

74.42

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: skodama636903@direct.med.utah.edu

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.

• University of Utah Adult Services

  • General Practice Physician
  • Salt Lake City, UT
  • NPI 1114321981
  Medicare reassignment NPD
• University of Utah Adult Services

  • Urology Physician
  • Salt Lake City, UT
  • NPI 1356745160
  NPD
• University of Utah Adult Services

  • Diagnostic Radiology Physician
  • Salt Lake City, UT
  • NPI 1598169419
  NPD

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

{
    "created_epoch": "1553126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1700346145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 2B200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N 1900 E RM 2B200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320002",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "110 Irving St NW Dept Of",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200103017",
            "country_code": "US",
            "telephone_number": "202-877-8035",
            "fax_number": "202-877-5435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUKUTOMI",
        "first_name": "SAMANTHA",
        "middle_name": "S.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-21",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "UT",
            "license": "13312645-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "skodama636903@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "KODAMA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Reproductive Endocrinology Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Reproductive Endocrinology Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.