Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Samantha Bengtzen Derzon, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1053060939

Samantha Bengtzen Derzon, MD is a Family Practice in Provo, Utah. Qualified in 2022, 4 years ago. Practices with Ihc Health Services Inc, a 3,947-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
4
Licensed in
UT
In the registry since
2022
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

475 W 940 N
Provo, UT 84604-3301
Phone: (801) 357-7940
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 395 W Cougar Blvd Ste 205, Provo, UT 84604-3328 — (801) 357-1770

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 135169241205 (UT)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1053060939
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 19, 2022
Last updated in NPPESMay 28, 2025
Certification dateMay 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ihc Health Services Inc — 3947 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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