Individual provider Active NPI

Glen M. Rogers, PA-C

  • Surgical Physician Assistant
  • Seattle, WA
National Provider Identifier
1598733172
Registry record updated Jan 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA60299909 Issued in WA
Practice address
550 17TH Ave FL 5
Seattle, WA 98122-5788
Phone
(206) 320-2800
Fax
(206) 320-2827
NPI assigned
Mar 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA60299909 WA
Surgical Physician Assistant 363AS0400X PA60299909 WA Primary

Addresses

Primary practice location

550 17TH Ave FL 5
Seattle, WA 98122-5788

Mailing address

PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476

Other practice location 1

751 NE Blakely Dr Ste 4020
Issaquah, WA 98029-6201
Phone (206) 623-0922

Other identifiers 1

IdentifierTypeStateIssuer
2023881MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130121000074 WA Practitioner - Physician Assistant 5597774877 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians
Proliance Surgeons Inc P SGroup PAC ID 8527972900, 395 clinicians

Practice addresses (Care Compare)

550 17TH Ave
Suite 500
Seattle, WA 98122-5789
Phone (206) 320-2800

601 Broadway
FL 6
Seattle, WA 98122-5330
Phone (206) 633-8100

747 Broadway
Seattle, WA 98122-4379
Phone (425) 778-8116

751 NE Blakely Dr
Issaquah, WA 98029-6201
Phone (425) 313-5422

801 Broadway
Suite 617
Seattle, WA 98122-4319
Phone (206) 623-0922

Hospital & facility affiliations

  • Swedish Medical Center Hospital, Seattle, WA, CCN 500027
  • Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025
  • Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Proliance Surgeons, Inc., P.S Surgical CurrentSince Jan 2, 2013 Accepting new patients
Proliance Surgeons Inc P S Surgical CurrentSince Jan 2, 2013 Accepting new patients
Swedish Health Services CurrentSince Jan 5, 2026 Accepting new patients
Swedish Health Services Past Accepting new patients

Locations

7320 216th St SW
Ste 320
Edmonds, WA 98026
Phone (425) 673-3900

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

751 NE Blakely Dr
Ste 4020
Issaquah, WA 98029
Phone (425) 313-7077

550 17th Ave
Fl 5
Seattle, WA 98122
Phone (206) 386-3880

805 Madison St
Ste 901
Seattle, WA 98104
Phone (206) 264-8100

801 Broadway
Ste 617
Seattle, WA 98122
Phone (206) 623-0922

550 17th Ave
Ste 500
Seattle, WA 98122
Phone (206) 320-2451

601 Broadway
Seattle, WA 98122
Phone (206) 215-6415

601 Broadway
Fl 6
Seattle, WA 98122
Phone (206) 633-8100

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

Interoperability endpoints

  • Direct secure messaging: m.glen.rogers@direct.vmmc.org
  • Direct secure messaging: grogers1043081@wm.providencedirect.org

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1598733172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 17TH AVE FL 5",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225788",
            "telephone_number": "206-320-2800",
            "fax_number": "206-320-2827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "751 NE Blakely Dr Ste 4020",
            "address_purpose": "LOCATION",
            "city": "Issaquah",
            "state": "WA",
            "postal_code": "980296201",
            "country_code": "US",
            "telephone_number": "206-623-0922",
            "fax_number": "206-623-1588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "GLEN",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA60299909",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60299909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2023881",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.