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KELLY L DUSTIN DO
NPI 1114957362
Family Medicine in Rexburg, ID

Active since July 04, 2006PECOS EnrolledAccepts Medicare Assignment
21 WINN DR, REXBURG, ID 83440(208) 881-5222(877) 441-4715 Get Directions Write a Review

NPPES record last updated: November 19, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelly L Dustin Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLY L DUSTIN DO (NPI 1114957362) is an individual family medicine provider in Rexburg, Idaho, licensed in Idaho (O-0459) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Madison Memorial Hospital, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (2006).

NPPES Registry Identity

NPI1114957362
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameKELLY L DUSTINCredential: DO
Location Address21 WINN DRRexburg, ID 83440-5277
Mailing Address794 Eastland DrTwin Falls, ID 83301-6856 · (208) 734-3312 · Fax (208) 734-5036
Phone(208) 881-5222
Fax(877) 441-4715
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2006
Enumeration DateJuly 4, 2006
Last NPPES UpdateNovember 19, 2019
✔ NPI 1114957362 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ID · O-0459
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License MR0875 (ID)
21 WINN DR, Rexburg, ID 83440
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Other Identifiers 1

Medicaid8035175ID

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly L Dustin Do 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.

PECOS PAC ID2264583459
PECOS Enrollment IDI20090629000517
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 7

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
76 services55 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
54 services33 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
42 services34 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
30 services23 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
23 services23 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
17 services13 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Madison Memorial Hospital

Acute Care Hospitals · Rexburg, ID
5/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number130025
Location450 East Main StreetRexburg, ID 83440 · Madison County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 83440 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Portable oxygen contents, gaseous, 1 month's supply = 1 unit E0443
DME-Oxygen and Supplies · category DC000N
2 suppliers23 claims23 services$50.66 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
1 supplier24 claims24 services$180.16 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AUSTIN C GILLETTE
Family Medicine
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222
FALL RIVER MEDICAL, PLLC
Clinic/Center (Primary Care)
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222
DR. SHELBY ELIZABETH NORDMANN MD
Family Medicine
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222
JEREMIAH D BUEHNER PA
Physician Assistant
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222
BRENNEN LARSEN PA-C
Physician Assistant
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222
JOSHUA L GILGEN PA-C
Physician Assistant
21 WINN DR
REXBURG, ID 83440
Madison County (208) 881-5222

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 Kelly Dustin's NPI number?

The NPI number for Kelly Dustin is 1114957362. It was assigned to this individual provider in the NPPES registry on July 4, 2006.

Where is Kelly Dustin located?

Kelly Dustin practices at 21 Winn Dr, Rexburg, ID 83440. The listed phone number is (208) 881-5222.

What is Kelly Dustin's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Kelly Dustin enrolled in Medicare?

Yes. Kelly Dustin 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.

What insurance does Kelly Dustin accept?

Health plans from Moda Health Plan, Inc., PacificSource Health Plans, Providence Health Plan, Select Health and University of Utah Health Plans list Kelly Dustin 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 Kelly Dustin affiliated with any hospitals?

According to CMS data, Kelly Dustin is affiliated with Madison Memorial Hospital.

When was this NPI record last updated?

The NPPES record for Kelly Dustin was last updated on November 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.