Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Jack William Dormer, PA

Individual provider Physician Assistant · NPI 1285317024

Jack William Dormer, PA is a Physician Assistant in Williamsville, New York. Qualified in 2023, 3 years ago. Practices with University Orthopaedic Services Inc, a 114-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
3
Licensed in
NY
In the registry since
2023
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

111 N Maplemere Rd Ste 100
Williamsville, NY 14221
Phone: (716) 204-3200
Fax: (716) 204-4337
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 030380 (NY)

Record details

NPI number1285317024
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 9, 2023
Last updated in NPPESAugust 9, 2023
Certification dateAugust 7, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice University Orthopaedic Services Inc. — 114 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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