MR. ROGER WILLIAM JR. CALVERT (PA-C) – Physician Assistant, NPI 1093080368

MR. ROGER WILLIAM JR. CALVERT (PA-C) is a healthcare provider. based in Seattle, Washington. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. PA602651123 (WA). The NPI Number for MR. ROGER WILLIAM JR. CALVERT (PA-C) is 1093080368

Main info

Male
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MR. ROGER WILLIAM JR. CALVERT (PA-C)
NPI
1093080368
Phone
(206) 834-5899
Address
1105 SPRING ST
Enumeration Date
19 March 2012
Last Update Date
19 March 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8646643984
Graduation Year
2011 (15 years ago)
PAC ID
0547425944
Group Practice PAC ID
1759731383
Professional Enrollment ID
I20151113002527
Address ID
WA981095214SE116XXNXXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:14State licenses:1Digital endpointsOther names

4,282 PHYSICIAN ASSISTANT in WA

Provider Addresses for MR. ROGER WILLIAM JR. CALVERT (PA-C)

  • 1105 SPRING ST

    #202

    SEATTLE, WA 981043527

    Phone: (206) 834-5899

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151113002527IPhysician AssistantWATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1759731383View full group profile
NameSpecialtyState
Physician AssistantWA
Physician AssistantFL
Nurse PractitionerOR
Physician AssistantWA
Physician AssistantWA
Nurse PractitionerOR
Nurse PractitionerWA
Nurse PractitionerVA
Physician AssistantIL
Physician AssistantWA

Reviews

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Frequently asked questions

Can I verify MR. ROGER WILLIAM JR. CALVERT (PA-C) with an NPI only?
You can start verification with NPI 1093080368 for MR. ROGER WILLIAM JR. CALVERT (PA-C), then check state licensing separately.
Does the file indicate MR. ROGER WILLIAM JR. CALVERT (PA-C) is practicing under active NPI?
Directory data currently reports MR. ROGER WILLIAM JR. CALVERT (PA-C) as active.
What healthcare role does MR. ROGER WILLIAM JR. CALVERT (PA-C) hold?
Scheduling teams often label MR. ROGER WILLIAM JR. CALVERT (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MR. ROGER WILLIAM JR. CALVERT (PA-C) based?
MR. ROGER WILLIAM JR. CALVERT (PA-C) is tied to Seattle, Washington in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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