SAMANTHA S. FUKUTOMI MD, MPH
NPI 1700346145
Obstetrics & Gynecology - Reproductive Endocrinology in Salt Lake City, UT

Q: What is the provider's specialty?

The provider's specialty is Obstetrics & Gynecology with taxonomy code 207VE0102X and a focus in Reproductive Endocrinology.

Active since March 21, 2019PECOS Enrolled

30 N 1900 E RM 2B200, SALT LAKE CITY, UT 84132(801) 581-2121 Get Directions Write a Review

NPPES record last updated: January 26, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 26, 2026, Sep 1, 2023, Mar 28, 2023 and 1 more (4 updates tracked since 2019).

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About Samantha S. Fukutomi Md, Mph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SAMANTHA S. FUKUTOMI MD, MPH (NPI 1700346145) is an individual reproductive endocrinology provider in Salt Lake City, Utah, licensed in Utah (13312645-1205) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS and maintains a secondary practice location in Washington.

NPPES Registry Identity

NPI1700346145

Entity TypeIndividualFemale

Primary Taxonomy207VE0102X

Provider Legal NameSAMANTHA S. FUKUTOMICredential: MD, MPH

Location Address30 N 1900 E RM 2B200Salt Lake City, UT 84132-0002

Mailing Address30 N 1900 E Rm 2b200Salt Lake City, UT 84132-0002 · (801) 581-2121

Phone(801) 581-2121

Sole ProprietorNo

Enumeration DateMarch 21, 2019

Last NPPES UpdateJanuary 26, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 26, 2026

✔ NPI 1700346145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & Gynecology · Reproductive EndocrinologyAllopathic & Osteopathic Physicians

Taxonomy Code207VE0102X

License✔ Licensed in UT · 13312645-1205

Definition

An obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility.

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

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Other Names 1

Former Name (1)Samantha Kodama

Secondary Practice Location 1

Location 1110 Irving St NW Dept OfWashington, DC 20010-3017 · Phone (202) 877-8035 · Fax (202) 877-5435

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samantha S. Fukutomi Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 84132 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$125.70 typical visit price

range $54.34 – $166.03

Typical copayment $31.42 (range $13.58 – $41.50)

Most-billed visit code 99204

Established Patient

$96.35 typical visit price

range $17.23 – $135.20

Typical copayment $24.08 (range $4.30 – $33.80)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 18

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JEANETTE RUTH CARPENTER M.D.

Obstetrics & Gynecology (Maternal & Fetal Medicine)