Individual provider

Dustin Fanciullo, M.D.

Vascular Surgery Physician Surgery Physician Medicare enrolled

Dustin Fanciullo, M.D. is a Vascular Surgery Physician in Salt Lake City, UT, registered under NPI 1013164052. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty.

Getting there

The practice address on file is 1160 E 3900 S STE 3100, Salt Lake City, UT 84124. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.

1160 E 3900 S STE 3100, Salt Lake City, UT 84124 Open in Google Maps →

Credentials and Medicare

State licence
LicenceStateSpecialty
14267138-1205 UT Vascular Surgery Physician primary
14267138-1205 UT Surgery Physician

This provider holds licence 14267138-1205 issued in UT. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.

Medicare (PECOS)
Status
Approved
Provider type
Practitioner - Vascular Surgery
PAC ID
0042488041

Medicare enrolment is recorded as approved under the provider type Practitioner - Vascular Surgery. This means the provider is enrolled to bill Medicare, though it does not tell you whether they are currently accepting new Medicare patients. Call the office to confirm.

What Vascular Surgery covers

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. NUCC Health Care Provider Taxonomy, code 2086S0129X
Allopathic & Osteopathic Physicians Surgery Vascular Surgery

All registered taxonomy codes

This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.

CodeSpecialtyLicenceState
2086S0129X Vascular Surgery Physician Vascular Surgery 14267138-1205 UT primary
208600000X Surgery Physician 14267138-1205 UT

The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.

Full NPPES record

An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.

NPI1013164052 valid check digit
Entity typeIndividual (NPI-1)
Enumeration dateAug 21, 2008
Last updatedMar 2, 2026
StatusActive
Sole proprietorNo
CredentialM.D.
Practice address 1160 E 3900 S STE 3100
Salt Lake City, UT 84124
(801) 262-2806
Mailing address PO BOX 281490
Atlanta, GA 30384
This record was updated on Mar 2, 2026, which is recent enough that the contact details are likely still accurate.

Number check

1013164052 passes the NPI check digit test The final digit 2 matches the value computed from the first nine digits, so this is a well-formed NPI.
How the check works, step by step

Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.

Digit 8 0 8 4 0 1 0 1 3 1 6 4 0 5
Doubled? ×2 ×2 ×2 ×2 ×2 ×2 ×2
Value 8 0 8 8 0 2 0 2 3 2 6 8 0 1

Sum = 48 · next multiple of 10 = 50 · check digit = 2 · actual last digit = 2

A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.

Common questions

What is NPI number 1013164052?
NPI 1013164052 is the National Provider Identifier assigned to Dustin Fanciullo, M.D. in Salt Lake City, UT. It is a 10-digit number issued by the Centers for Medicare & Medicaid Services and used on claims, referrals, and prescriptions to identify the provider.
What does Vascular Surgery cover?
A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.
How do I contact Dustin Fanciullo, M.D.?
The phone number on file with NPPES is (801) 262-2806, last updated Mar 2, 2026. Because NPPES is only updated when a provider files a change, call ahead to confirm the number and the current practice address before visiting.
Does Dustin Fanciullo, M.D. accept Medicare?
This NPI has an approved Medicare enrolment in PECOS, which means the provider is enrolled to bill Medicare. Enrolment does not guarantee they are accepting new Medicare patients — verify directly with the office.
Is NPI 1013164052 a valid number?
Yes. 1013164052 passes the Luhn check digit validation that CMS uses for NPI numbers, and it resolves to an active record in the registry.
How to use this page. Everything here comes from public federal records. Tips Health does not verify quality of care, confirm that a licence is currently active, or check malpractice history, and accepts no fees for placement. A listing is not a recommendation. Verify independently before seeking care.