NPIMap

Organization Active NPI

Mosaic Community Health

  • Federally Qualified Health Center (FQHC)
  • Bend, OR
National Provider Identifier
1346656444
Registry record updated Apr 20, 2023
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
1700 SE Tempest Dr
Bend, OR 97702-1884
Phone
(541) 383-3005
Fax
(541) 383-1883
NPI assigned
Jul 9, 2014
Organization subpart
Yes
Parent organization
MOSAIC COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Authorized official

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

Specialties & licenses 1

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

Addresses

Primary practice location

1700 SE Tempest Dr
Bend, OR 97702-1884

Mailing address

600 SW Columbia St
Suite 6210
Bend, OR 97702-1099
Phone (541) 323-3181

Other identifiers 1

IdentifierTypeStateIssuer
182960MedicaidOR

Other names 2

  • Ariel Glen & Ariel South Community Clinic Doing business as
  • Mosaic Medical Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 381958

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ARIEL GLEN & ARIEL SOUTH COMMUNITY CLINIC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 16, 2014
Last certification
Oct 16, 2014
Ownership / control type
Non-profit – corporation
Facility address
1700 SE Tempest Drive
Bend, OR 97702

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1404864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681948800000",
    "number": "1346656444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SW COLUMBIA ST",
            "address_2": "SUITE 6210",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021099",
            "telephone_number": "541-323-3181",
            "fax_number": "541-706-9895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 SE TEMPEST DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021884",
            "telephone_number": "541-383-3005",
            "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": "2014-07-09",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "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": "NP"
    },
    "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": "Ariel Glen & Ariel South Community Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Mosaic Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.