Doctor profile · Federal record
Dr. Samuel Southam, MD
Diagnostic Radiology Physician (CMS: Diagnostic Radiology) · Diagnostic Radiology Physician · Provo, UT
- NPI 1104868850
- Accepts Medicare
- 23 yrs in practice
- Licensed in 2 states
- Male
- Group practice
- No sanctions
Practice & contact
- Primary practice
-
1034 N 500 W
Provo, UT 846043380
(801) 357-7850
fax (801) 357-7626
Credentials & registration
- NPI registered
- June 2006 — 20 yrs on file
- Profile last updated
- June 10, 2021
- Year of graduation
- 2003 — 23 yrs since
- Specialty taxonomy
- 2085R0202X — NUCC code
- State licenses (2)
- New Mexico #2005-0536 · Utah #12285899-1205
- Medicaid
- NM #76673855
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1104868850. Last verified May 11, 2026.Medicare procedures · 2023
Top services delivered
Total services
2,352
Distinct HCPCS
10
Medicare allowed
$88,056
| HCPCS | Description | Services | Patients | Avg allowed | |
|---|---|---|---|---|---|
71045 |
X-ray of chest, 1 view | 479 | 427 | $8 | |
74177 |
Ct scan of abdomen and pelvis with contrast | 220 | 217 | $84 | |
71046 |
X-ray of chest, 2 views | 114 | 111 | $10 | |
71275 |
Ct scan of blood vessels of chest with contrast | 106 | 106 | $83 | |
70450 |
Ct scan head or brain without contrast | 90 | 87 | $38 | |
73721 |
Mri scan of leg joint without contrast | 77 | 75 | $62 | |
74018 |
X-ray of abdomen, 1 view | 74 | 72 | $8 | |
71260 |
Ct scan of chest with contrast | 73 | 73 | $52 | |
74176 |
Ct scan of abdomen and pelvis without contrast | 69 | 67 | $80 | |
73221 |
Mri scan of arm joint without contrast | 59 | 56 | $63 |
In context: peer comparison
Among 23 peers in this city , average services per provider: 151. This provider delivers 16× the peer median.Hospital affiliations
Frequently asked questions
What is Dr. Samuel Southam's medical specialty?
Dr. Samuel Southam practices Diagnostic Radiology Physician in Provo, UT.
Where does Dr. Samuel Southam practice?
Dr. Samuel Southam practices at 1034 N 500 W, Provo, UT 846043380. Office phone: 8013577850.
What is Dr. Samuel Southam's NPI?
Dr. Samuel Southam's National Provider Identifier (NPI) is 1104868850, issued by NPPES.
Does Dr. Samuel Southam accept Medicare assignment?
Yes. Dr. Samuel Southam accepts Medicare assignment, meaning Medicare-allowed amounts are accepted as full payment for covered services.
What procedures does Dr. Samuel Southam commonly perform?
Top Medicare-reported procedures in 2023: X-ray of chest, 1 view (HCPCS 71045); Ct scan of abdomen and pelvis with contrast (HCPCS 74177); X-ray of chest, 2 views (HCPCS 71046). Source: CMS Medicare Physician & Other Practitioners file.