Dustin John Fanciullo, M.D.
NPI 1013164052ActiveIndividual· Surgery, Vascular Surgery· Salt Lake City, UT
Surgery, Vascular Surgery (M.D.) in Salt Lake City, Utah, trained at University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) (class of 2004). 158 Medicare patients in 2024, $42,671 paid; nearly all of their 453 Part D prescriptions were generic (91%). Bolton Medical Inc reported $76.96 in payments in 2025, mostly food and beverage.
Overview
| NPI | 1013164052 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | M.D. |
| Sole proprietor | No |
| NPI issued | Aug 21, 2008 |
| Last updated in NPPES | Mar 2, 2026 |
| Certified by provider | Mar 2, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Surgery, Vascular Surgery Primary | 2086S0129X | 14267138-1205 | UT |
| Surgery | 208600000X | 14267138-1205 | UT |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Vascular Surgery (NY); Practitioner - Vascular Surgery (UT) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 158 |
|---|---|
| Services billed | 296 across 50 procedure codes |
| Paid by Medicare | $42,671 |
Part D prescriptions in 2024
| Prescriptions (claims) | 453 · 609 30-day fills |
|---|---|
| Patients | 124 |
| Total drug cost | $42,806 |
| Generic share | 91% of claims |
Education and affiliations
| Medical school | University of Illinois College of Med (Chi/Peor/Rock/Chm-Urb) |
|---|---|
| Graduation year | 2004 |
| Medicare specialty | Vascular Surgery |
| Secondary specialties | General Surgery |
Medical groups
- Canton-Potsdam HospitalPotsdam, NY · 252 clinicians
- Clifton Springs Sanitarium CoClifton Springs, NY · 221 clinicians
- Mountainstar Cardiovascular Services LLCSalt Lake City, UT · 14 clinicians
Hospital affiliations
- Canton-Potsdam HospitalPotsdam, NY
- Clifton Springs Hospital and ClinicClifton Springs, NY
- Rochester General HospitalRochester, NY
- St Mark's HospitalSalt Lake City, UT
Other facilities
- Rochester Regional Health Home CareHome health agency · Rochester, NY
Industry payments (Open Payments)
- 2025$76.96 · 1 payment from 1 company
- 2024$122.89 · 2 payments from 2 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Bolton Medical Inc | $76.96 | 1 |
What the 2025 payments were for
- Food and Beverage$76.96 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
Other Surgery, Vascular Surgery providers in Salt Lake City
- 1437347770
- 1720482532
- 1548366198
- 1831287242
- 1982754107
- 1205457009
- 1235398645
- 1043264070
- 1962592576
- 1023468238
- 1437249042
- 1942866967