DUSTIN J. FANCIULLO M.D. – NPI #1013164052
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

Health Care Provider Taxonomy Code for Surgery

DUSTIN FANCIULLO is a surgeon located in SALT LAKE CITY, UT. NPPES has assigned the NPI number 1013164052 to DUSTIN FANCIULLO on August 21, 2008. It is a Type-1 NPI, indicating this NPI number is associated with an individual. According to the NPI Registry, there are 5 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was last updated on Mar 02, 2026. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for DUSTIN FANCIULLO below.

NPI Profile for
DUSTIN J. FANCIULLO

NPI Number
1013164052
Enumeration Date

(about 18 years ago)
Entity Type
Type-1  Individual (Male)
Legal Name
DUSTIN J. FANCIULLO
Credentials
M.D.
Primary location
1160 E 3900 S STE 3100
SALT LAKE CITY, UT 84124-1290
Phone: (801) 262-2806 Fax:
5 Other location(s):
4 Coulter Rd Ste 1680
Clifton Springs, NY 14432-1122
Phone: (585) 922-5550
Fax: (585) 922-5950
875 Pre Emption Rd
Geneva, NY 14456-2042
Phone: (315) 759-5320
Fax: (315) 351-3971
165 E Union St Ste 327
Newark, NY 14513-1557
Phone: (315) 359-2661
Fax: (315) 331-6820
2655 Ridgeway Ave Ste 240
Rochester, NY 14626-4296
Phone: (585) 723-7060
Fax: (315) 331-6820
30 Hagen Dr Ste 120
Rochester, NY 14625-2658
Phone: (585) 922-5300
Fax: (585) 922-0450
Mailing address
PO BOX 281490
ATLANTA, GA 30384-1490
Phone: Fax:
Sole Proprietor
No
Updated
Certification Date
Mar 02, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)		 UT 14267138-1205
208600000X
- Surgery		 UT 14267138-1205

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.

Additional Information

Education
UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB) - Graduated 2004
Accepts Medicare
This provider accepts Medicare-approved amount as payment in full. The Medicare-approved amount is the total the provider can be paid. When a provider accepts the Medicare-approved amount as payment, you won't be billed for more than the Medicare deductible & coinsureance.
Medicare Ordering & Referring
Provider can:
  • Refer to Part B
  • Order Durable Medical Equipment
  • Refer to Home Health Agency
  • Order Power Mobility Devices
Affiliations
DUSTIN FANCIULLO is affiliated with the following medical group(s):
  • HOSPITAL
    • CLIFTON SPRINGS HOSPITAL AND CLINIC
      2 COULTER ROAD
      CLIFTON SPRINGS, NY 14432
    • NEWARK-WAYNE COMMUNITY HOSPITAL
      111 DRIVING PARK AVENUE
      NEWARK, NY 14513
    • ROCHESTER GENERAL HOSPITAL
      1425 PORTLAND AVENUE
      ROCHESTER, NY 14621
  • HOME HEALTH AGENCY
    • ROCHESTER REGIONAL HEALTH HOME CARE
      330 MONROE AVENUE
      ROCHESTER, NY 14607

Why is my NPI data (personal information) being displayed publicly?
If you have an active NPI profile, your profile is required to be disclosed according to the FOIA and eFOIA. HIPAA also requires covered providers to share their NPI with other providers, health plans, clearinghouses and any entity that may need it for billing purposes.

How do I correct or change the NPI data displayed here?
At any time, providers can make changes to their NPI profile at NPPES. Login to NPPES to make changes online or call (800) 465-3203 for assistance. Changes made at NPPES will be reflected on this web site within a few days.

Can I hide my NPI profile from the public?
Unfortunately, No. The NPPES discloses health care provider data under the Freedom of Information Act to the public, which means anyone may request such information directly from the National Plan & Provider Enumeration System. See the complete CMS Data Dissemination Notice here.