Samuel Lynn Southam, MD in Provo, UT - Medicare Diagnostic Radiology

Samuel Lynn Southam, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Provo, Utah. He went to University Of Colorado School Of Medicine, Denver and graduated in 2003 and has 21 years of diverse experience with area of expertise as Diagnostic Radiology. He is a member of the group practice Intermountain Healthcare Services, Inc, Utah Valley Radiology Associates Inc and his current practice location is 1034 N 500 W, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 357-7850.

Samuel Lynn Southam is licensed to practice in New Mexico (license number 2005-0536) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104868850.

Contact Information

	Samuel Lynn Southam, MD
	1034 N 500 W, Provo, UT 84604-3380
	(801) 357-7850
	(801) 357-7626

Map and Direction

Physician's Profile

Full Name	Samuel Lynn Southam
Gender	Male
Speciality	Diagnostic Radiology
Experience	21 Years
Location	1034 N 500 W, Provo, Utah
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Samuel Lynn Southam attended and graduated from University Of Colorado School Of Medicine, Denver in 2003

NPI Data:

NPI Number: 1104868850
Provider Enumeration Date: 06/10/2006
Last Update Date: 06/10/2021

Medicare PECOS Information:

PECOS PAC ID: 7416954474
Enrollment ID: I20210806002589

Medical Identifiers

Medical identifiers for Samuel Lynn Southam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104868850	NPI	-	NPPES
76673855	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	12285899-1205 (Utah)	Secondary
2085R0202X	Radiology - Diagnostic Radiology	2005-0536 (New Mexico)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Utah Valley Hospital	Provo, UT	Hospital
San Juan Hospital	Monticello, UT	Hospital
American Fork Hospital	American fork, UT	Hospital
Park City Hospital	Park city, UT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Intermountain Healthcare Services, Inc	1850209420	3063
Utah Valley Radiology Associates Inc	1759286990	34

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Samuel Lynn Southam allows following entities to bill medicare on his behalf.

Entity Name	Ihc Health Services Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079

Entity Name	Utah Valley Radiology Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265483598 PECOS PAC ID: 1759286990 Enrollment ID: O20031202000093

Entity Name	Green River Radiology Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508533878 PECOS PAC ID: 5294123063 Enrollment ID: O20211027002062

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Samuel Lynn Southam is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Samuel Lynn Southam, MD 1034 N 500 W, Provo, UT 84604-3380 Ph: (801) 357-7850	Samuel Lynn Southam, MD 1034 N 500 W, Provo, UT 84604-3380 Ph: (801) 357-7850

Reviews and Comments

Radiology Doctors in Provo, UT

Dr. Daniel Lyman Corey, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-225-6246 Fax: 801-225-1525
Scott D Valadez, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 112, Provo, UT 84604 Phone: 801-812-4624 Fax: 801-812-4699
Mark S Asay, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-373-7850
Dr. Derek Scott Bergeson, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Attn Credentialing, Provo, UT 84604 Phone: 801-354-8225 Fax: 801-418-0941
Dalton H Wright, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1055 N 500 W, Suite 112, Provo, UT 84604 Phone: 801-812-4624 Fax: 801-812-4699
John S Collins, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-373-7850

Samuel Lynn Southam, MD - Medicare Diagnostic Radiology in Provo, UT