Individual provider Active NPI

Samantha Erika Keefer, MD

  • General Practice Physician
  • San Diego, CA
National Provider Identifier
1760126676
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
0101279743 Issued in VA
Practice address
2841 Rendova Rd
San Diego, CA 92155-5490
Phone
(619) 437-2860
NPI assigned
Apr 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X
Family Medicine Physician 207Q00000X 0101279743 VA
General Practice Physician 208D00000X 0101279743 VA Primary

Addresses

Primary practice location

2841 Rendova Rd
San Diego, CA 92155-5490

Mailing address

2841 Rendova Rd
San Diego, CA 92155-5490
Phone (619) 437-2860

Other practice location 1

PSC 475 Box 1
Fpo, AP 96350-1200
Phone (315) 243-7144

Other practice location 2

U.S. Naval Hospital, Okinawa, Camp Foster
Fpo, AP 96362
Phone (098) 971-9355

Other names 1

  • Samantha Erika Grutzner Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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

Enrollment IDStateProvider typePAC IDDetails
I20231116002242 VA Order and Referring Only - Family PracticePractitioner - Family Practice 0244687952

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101279743VAMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1760126676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2841 RENDOVA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555490",
            "telephone_number": "619-437-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2841 RENDOVA RD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921555490",
            "telephone_number": "619-437-2860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PSC 475 Box 1",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AP",
            "postal_code": "963501200",
            "country_code": "US",
            "telephone_number": "315-243-7144",
            "country_name": "United States",
            "address_type": "MIL"
        },
        {
            "address_1": "U.S. Naval Hospital, Okinawa, Camp Foster",
            "address_purpose": "LOCATION",
            "city": "FPO",
            "state": "AP",
            "postal_code": "96362",
            "country_code": "US",
            "telephone_number": "098-971-9355",
            "country_name": "United States",
            "address_type": "MIL"
        }
    ],
    "basic": {
        "last_name": "KEEFER",
        "first_name": "SAMANTHA",
        "middle_name": "ERIKA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101279743",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101279743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SAMANTHA",
            "last_name": "GRUTZNER",
            "middle_name": "ERIKA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.