GLEN STANLEY ROSEBOROUGH MD NPI 1518903186

NPI Information

  • NPI: 1518903186
  • Provider Name: GLEN STANLEY ROSEBOROUGH, MD
  • Classification: Surgery - 2086S0129X
  • Specialization: Vascular Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 2480 LIBERTY ST NE
    SUITE 110
    SALEM, OR
    ZIP 97301
  • Phone: (503) 371-1756

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NPI Details

Glen Stanley Roseborough, MD is a vascular surgery surgery in Salem, OR with 35 years of experience. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. Glen Stanley Roseborough, MD NPI is 1518903186. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2480 LIBERTY ST NE
SUITE 110
SALEM, OR
ZIP 97301-381
Phone: (503) 371-1756
Fax: (503) 584-7971

The NPI 1518903186 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Complete ultrasound study of arm and leg arteries (HCPCS:93923)
  • Ultrasound of hemodialysis access (HCPCS:93990)
  • Ultrasound of both sides of head and neck blood flow (HCPCS:93880)
  • Complete ultrasound of aorta, vena cava, groin vessels or bypass grafts (HCPCS:93978)
  • Ultrasound of leg arteries or artery grafts (HCPCS:93925)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Use of a drug to induce depression of consciousness by physician performing a procedure, each additional 15 minutes (HCPCS:99153)
  • Ultrasound of one leg arteries or artery grafts (HCPCS:93926)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Ultrasound study of arm or leg veins with compression and maneuvers (HCPCS:93970)
  • Ultrasound study of one arm or leg veins with compression and maneuvers (HCPCS:93971)
  • New patient office or other outpatient visit, 60-74 minutes (HCPCS:99205)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • Complete ultrasound of abdomen and pelvis artery and vein blood flow (HCPCS:93975)
  • Ultrasonic guidance for blood vessel access (HCPCS:76937)
  • Leg revascularization (restoring blood flow) (HCPCS:NAN01)

The enumeration date for this NPI number is 6/21/2006 and was last updated on 11/13/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryMD150190OREGONNo
22086S0129XSurgeryVascular SurgeryMD150190OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1P00800072OTHEROREGONRAILROAD MEDICARE
2500612667MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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