NPIMap

Organization Active NPI

Mosaic Medical

  • Federally Qualified Health Center (FQHC)
  • Redmond, OR
National Provider Identifier
1689194474
Registry record updated Feb 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOSAIC MEDICAL
Practice address
675 SW Rimrock Way
Redmond, OR 97756-1931
Phone
(541) 923-5800
Fax
(541) 383-1883
NPI assigned
Jun 22, 2017
Organization subpart
Yes
Parent organization
MOSAIC MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 28, 2018

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

Authorized official

Name
Megan Haase
Title
Ceo
Phone
(541) 383-3005

Specialties & licenses 1

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

Addresses

Primary practice location

675 SW Rimrock Way
Redmond, OR 97756-1931

Mailing address

600 SW Columbia St Ste 6210
Bend, OR 97702-1099
Phone (541) 383-3005

Other identifiers 1

IdentifierTypeStateIssuer
182960MedicaidOR

Other names 2

  • Mosaic Medical Redmond High School Based Health Center Doing business as
  • Redmond High School Based Health Center Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
38D2135984Mosaic-Redmond High School Based Health675 SW Rimrock Way, Redmond, OR 97756Certificate of waiverApr 14, 2027

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

NPI Registry JSON

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519776000000",
    "number": "1689194474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 SW COLUMBIA ST STE 6210",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977021099",
            "telephone_number": "541-383-3005",
            "fax_number": "541-383-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SW RIMROCK WAY",
            "city": "REDMOND",
            "state": "OR",
            "postal_code": "977561931",
            "telephone_number": "541-923-5800",
            "fax_number": "541-383-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOSAIC MEDICAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOSAIC MEDICAL",
        "enumeration_date": "2017-06-22",
        "last_updated": "2018-02-28",
        "status": "A",
        "authorized_official_last_name": "HAASE",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "541-383-3005"
    },
    "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 Redmond High School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Redmond High School Based Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redmond, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.