DUSTIN JOHN FANCIULLO M.D.
NPI 1013164052
Surgery - Vascular Surgery in Salt Lake City, UT
About Dustin John Fanciullo M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DUSTIN JOHN FANCIULLO M.D. (NPI 1013164052) is an individual vascular surgery provider in Salt Lake City, Utah, licensed in Utah (14267138-1205) and active in the NPI registry since August 2008. He is enrolled in Medicare PECOS, is affiliated with Rochester General Hospital, and is a graduate of University Of Illinois College Of Med (chi/peor/rock/chm-urb) (2004).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dustin John Fanciullo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignments
8Medicare enrollment records show Dustin Fanciullo reassigns Medicare billing to 8 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salt Lake City, UT 84124
- Reassigned Medicare billing, Utah enrollment
- 13 clinicians in this Medicare group
Warsaw, NY 14569
- Reassigned Medicare billing, New York enrollment
- 1,030 clinicians in this Medicare group
Rochester, NY 14624
- Reassigned Medicare billing, New York enrollment
- 1,442 clinicians in this Medicare group
Rochester, NY 14626
- Reassigned Medicare billing, New York enrollment
- 2,285 clinicians in this Medicare group
Clifton Springs, NY 14432
- Reassigned Medicare billing, New York enrollment
- 872 clinicians in this Medicare group
Gouverneur, NY 13642
- Reassigned Medicare billing, New York enrollment
- 143 clinicians in this Medicare group
Potsdam, NY 13676
- Reassigned Medicare billing, New York enrollment
- 414 clinicians in this Medicare group
Massena, NY 13662
- Reassigned Medicare billing, New York enrollment
- 176 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Hospital Affiliations CMS Care Compare 4
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Rochester General Hospital
Acute Care Hospitals · Rochester, NYCanton-Potsdam Hospital
Acute Care Hospitals · Potsdam, NYClifton Springs Hospital And Clinic
Acute Care Hospitals · Clifton Springs, NYSt Mark's Hospital
Acute Care Hospitals · Salt Lake City, UTPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 84124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Other Providers at the Same Location NPPES 3
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Dustin Fanciullo's NPI number?
The NPI number for Dustin Fanciullo is 1013164052. It was assigned to this individual provider in the NPPES registry on August 21, 2008.
Where is Dustin Fanciullo located?
Dustin Fanciullo practices at 1160 E 3900 S Ste 3100, Salt Lake City, UT 84124. The listed phone number is (801) 262-2806.
What is Dustin Fanciullo's specialty?
The primary specialty registered for this NPI is Surgery, specializing in Vascular Surgery, with taxonomy code 2086S0129X.
Is Dustin Fanciullo enrolled in Medicare?
Yes. Dustin Fanciullo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organizations bill Medicare for Dustin Fanciullo's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dustin Fanciullo reassigns Medicare benefits to 8 organizations: Mountainstar Cardiovascular Services LLC (Salt Lake City, UT), Western New York Medical Practice PC (Warsaw, NY), The Unity Hospital Of Rochester (Rochester, NY), Rochester General Hospital (Rochester, NY), Clifton Springs Sanitarium Co (Clifton Springs, NY) and 3 more organizations, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Dustin Fanciullo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Dustin Fanciullo accept?
Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Dustin Fanciullo as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Dustin Fanciullo affiliated with any hospitals?
According to CMS data, Dustin Fanciullo is affiliated with Rochester General Hospital, Canton-Potsdam Hospital, Clifton Springs Hospital And Clinic and St Mark's Hospital.
When was this NPI record last updated?
The NPPES record for Dustin Fanciullo was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Dustin John Fanciullo, M.D. · NPI 1013164052
Vascular Surgery physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since August 21, 2008.
## Identity
- **NPI:** 1013164052 (Entity type: Individual)
- **Enumerated:** August 21, 2008
- **Primary specialty:** Surgery - Vascular Surgery · taxonomy 2086S0129X
- **State license:** 14267138-1205 (Utah)
- **Sole proprietor:** No
## Practice location
- **Address:** 1160 E 3900 S STE 3100, Salt Lake City, UT 84124-1290
- **Phone:** (801) 262-2806
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 8 organizations under Medicare reassignment (form CMS-855R): Mountainstar Cardiovascular Services LLC (NPI 1689721219, Salt Lake City, UT); Western New York Medical Practice PC (NPI 1306214689, Warsaw, NY); The Unity Hospital Of Rochester (NPI 1720471246, Rochester, NY); Rochester General Hospital (NPI 1356412712, Rochester, NY); Clifton Springs Sanitarium Co (NPI 1366505463, Clifton Springs, NY); and 3 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Illinois College Of Med, class of 2004
## Record status
- **NPPES last updated:** March 2, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1013164052) · Data from the CMS NPPES public registry.