JASON R PERICAK (NPI# 1689823411) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689823411 |
| Entity Type | Individual |
| Full Name | JASON R PERICAK |
| Credential | MD |
| Practice Address |
2 Columbia Dr J402 Tampa FL 33606-3508 |
| Practice Telephone | 8138447412 |
| Mailing Telephone | 8138447412 |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2019-04-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
256124 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 03193533 | 05 |
| Street Address |
2 COLUMBIA DR J402 |
| City | TAMPA |
| State | FL |
| Zip Code | 33606-3508 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407854383 | William Arthur Grass | Nurse Practitioner | 2 Columbia Dr, Suite A327, Tampa, FL 33606-3508 | 2005-07-13 |
| 1588989404 | Debra N Brosius | Psychologist | 2 Columbia Dr, Tampa, FL 33606-3683 | 2010-04-03 |
| 1235382789 | Christopher M Orenich | Nurse Anesthetist, Certified Registered | 2 Columbia Dr, Suite A327, Tampa, FL 33606-3508 | 2008-10-28 |
| 1568614121 | Anthony E Lumas | Nurse Anesthetist, Certified Registered | 2 Columbia Dr, Suite A327, Tampa, FL 33606-3508 | 2008-10-15 |
| 1235380239 | Zhen Li | Nurse Anesthetist, Certified Registered | 2 Columbia Dr, Suite A327, Tampa, FL 33606-3508 | 2008-10-08 |
| 1104075753 | Habib Ajami | Student in an Organized Health Care Education/Training Program | 2 Columbia Dr, J402, Tampa, FL 33606-3508 | 2008-09-18 |
| 1649429374 | Jose J Correa | Student in an Organized Health Care Education/Training Program | 2 Columbia Dr, J402, Tampa, FL 33606-3508 | 2008-09-18 |
| 1447409172 | Matthias Setzer | Student in an Organized Health Care Education/Training Program | 2 Columbia Dr, J402, Tampa, FL 33606-3508 | 2008-09-18 |
| 1740439413 | Sean A Phillips | Student in an Organized Health Care Education/Training Program | 2 Columbia Dr, J402, Tampa, FL 33606-3508 | 2008-09-17 |
| 1184870487 | Maria Catherine Monte | Registered Nurse | 2 Columbia Dr, Tampa, FL 33606-3508 | 2008-08-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235758749 | Seyed Shayan Ahmad Falasiri | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. #308, Tampa, FL 33606 | 2020-04-14 |
| 1174156400 | Jessica Styles | Specialist/Technologist | The University of Tampa, 401 W. Kennedy Blvd, Tampa, FL 33606 | 2020-02-14 |
| 1295389757 | David Green | Specialist/Technologist | 401 W. Kennedy Blvd Box: I, Tampa, FL 33606 | 2019-08-01 |
| 1417514720 | Four Winds Counseling LLC | Counselor | 611 West Bay Street, Tampa, FL 33606 | 2019-05-22 |
| 1699238014 | Azubuogu Charles Anudu | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd., Suite 308 Tampa, Fl 33606, Tampa, FL 33606 | 2019-04-11 |
| 1508327883 | D'arcy Jocelyn Arden Wainwright | Student in an Organized Health Care Education/Training Program | 17 David Blvd., Suite 308, Tampa, FL 33606 | 2019-03-28 |
| 1659851772 | Heather Widmer | Counselor | 202 N Howard Ave, Tampa, FL 33606 | 2018-08-17 |
| 1447737291 | Jonathan T Bell | Marriage & Family Therapist | 425 S. Orleans Ave, Tampa, FL 33606 | 2018-07-24 |
| 1184157539 | Alexander Lim | Student in an Organized Health Care Education/Training Program | 17 David Blvd, Suite 308, Tampa, FL 33606 | 2017-04-04 |
| 1760913057 | Melanie Loretta Bradley | Student in an Organized Health Care Education/Training Program | 17 Davis Blvd. Suite 308, University of South Florida, Morsani College of Medicin, Tampa, FL 33606 | 2017-03-27 |
| Find all providers in zip 33606 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144834763 | Tower Imaging LLC | Radiology | 17416 Brookside Trace Ct., Tampa, FL 33647-3589 | 2020-09-01 |
| 1366067712 | Baycare Outpatient Imaging LLC | Radiology | 711 S Dale Mabry Hwy, Tampa, FL 33609-4445 | 2020-06-11 |
| 1306482088 | Michael P. Flynn | Radiology | 1003 Bay Harbour Place, Tampa, FL 33602 | 2019-11-18 |
| 1528526977 | Raddoctor, Pa | Radiology | 9203 Pine Island Ct, Tampa, FL 33647-2301 | 2019-03-05 |
| 1588023261 | Florida Gulfcoast Medical Imaging LLC | Radiology | 9822 Tree Tops Lake Rd, Tampa, FL 33626-4764 | 2016-02-23 |
| 1063803302 | Ahmed Sherif | Radiology | 2 Tampa General Cir # 7035, Usf Dept of Radiology, South Tampa Center, Tampa, FL 33606-3603 | 2015-02-09 |
| 1780015297 | St. Joseph's Diagnostic Center, LLC. | Radiology | 2222 W Swann Ave, Tampa, FL 33606-2426 | 2013-12-09 |
| 1245576651 | Radiology Associates of Tampa Pa | Radiology | 5 Tampa General Cir Ste 800, Harborside Medical Clinic, Tampa, FL 33606-3601 | 2012-12-13 |
| 1427282151 | Eric Matthew Lenz | Radiology | 3004 W San Miguel St, Tampa, FL 33629-6043 | 2009-05-09 |
| 1699929380 | Charles Howard Fisher | Radiology | 4904 Andros Dr, Tampa, FL 33629-4802 | 2008-11-09 |
| Find all providers in TAMPA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.