Doctor profile · Federal record

Dr. SAMANTHA DERZON, MD

Family Medicine Physician (CMS: FAMILY PRACTICE) · Student in an Organized Health Care Education/Training Program · PROVO, UT

  • NPI 1053060939
  • Accepts Medicare
  • 4 yrs in practice
  • Female
  • Group practice
  • No sanctions

Practice & contact

Operates at 2 locations .

NPPES Updated May 11, 2026
Primary practice
475 W 940 N
PROVO, UT 846043301
(801) 357-7940
Additional location
395 W Cougar Blvd Ste 205
Provo, UT 846043328
(801) 357-1770

Credentials & registration

NPPES · NUCC
NPI registered
March 2022 — 4 yrs on file
Profile last updated
May 28, 2025
Year of graduation
2022 — 4 yrs since
Specialty taxonomy
207Q00000X — NUCC code
State license (1)
Utah #135169241205

Federal sanctions & exclusions

OIG LEIE Updated May 11, 2026

No sanctions, exclusions or revocations on file

Checked against OIG LEIE on NPI 1053060939. Last verified May 11, 2026.

Open Payments

Industry payments received

CMS Open Payments
All-time total
$3
Transactions
1
Manufacturers
1
Payer (manufacturer) Industry Txns Amount
Organon Llc 1 $3.02

By nature of payment

Food and Beverage
$3

Medicare Part D · 2023

Top prescriptions

CMS Part D Prescriber
Total claims
63
Patients
0
Total drug cost
$821
Drug Type Claims Patients Total cost
Famotidine Generic 15 0 $106
Atorvastatin Calcium Generic 13 0 $172
Potassium Chloride Generic 13 0 $273
Albuterol Sulfate Hfa (Albuterol Sulfate) Brand 11 0 $156
Alendronate Sodium Generic 11 0 $114

Hospital affiliations

CMS Hospital Compare