NPIMap

Organization Active NPI

Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Prineville, OR
National Provider Identifier
1205174653
Registry record updated Jul 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOSAIC COMMUNITY HEALTH
Practice address
757 NE 1St Street
Prineville, OR 97754-2003
Phone
(541) 323-4272
Fax
(541) 383-1883
NPI assigned
Jan 18, 2013
Organization subpart
Yes
Parent organization
MOSAIC COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2026

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

Authorized official

Name
Megan Haase, FNP
Title
Ceo
Phone
(541) 447-0707

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

757 NE 1St Street
Prineville, OR 97754-2003

Mailing address

PO Box 4228
Portland, OR 97208-4228
Phone (541) 617-5369

Other identifiers 1

IdentifierTypeStateIssuer
182960MedicaidOR

Other names 2

  • Mosaic Medical Doing business as
  • Mosaic Medical Crook Kids Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mosaic Medical28 organizations share this tax ID, including this one
Part of
Mosaic Medical

Other organizations with this tax ID 27

Organizations that report the same tax identification number in the National Provider Directory.

View all 27

Locations

757 E 1st St
Prineville, OR 97754
Phone (541) 323-4272

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1205174653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4228",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084228",
            "telephone_number": "541-617-5369",
            "fax_number": "541-323-3866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "757 NE 1ST STREET",
            "city": "PRINEVILLE",
            "state": "OR",
            "postal_code": "977542003",
            "telephone_number": "541-323-4272",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOSAIC COMMUNITY HEALTH",
        "enumeration_date": "2013-01-18",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "HAASE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-447-0707",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "182960",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mosaic Medical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mosaic Medical Crook Kids Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prineville, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.