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

Jason R Pericak, MD

Individual provider Diagnostic Radiology Physician · NPI 1689823411

Jason R Pericak, MD is a Diagnostic Radiology in Williamsville, New York. Graduated from State University of New York at Buffalo School of Medicine in 2004, 22 years ago. Practices with Western New York Radiology Associates LLC, a 28-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
22
Trained at
State University of New York at Buffalo School of Medicine
Licensed in
NY
In the registry since
2008
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

111 N Maplemere Rd Ste 120
Williamsville, NY 14221-3178
Phone: (716) 836-4646
Fax: (716) 836-4696
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Diagnostic Radiology Physician (primary) Taxonomy 2085R0202X · Licence 256124 (NY)

Record details

NPI number1689823411
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 17, 2008
Last updated in NPPESAugust 21, 2023
Certification dateAugust 21, 2023

Medicare enrollment

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

Medicare specialtyDIAGNOSTIC RADIOLOGY
Medical schoolSTATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE
Graduated 2004 (22 years in practice)
Group practice Western New York Radiology Associates Llc — 28 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

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