MOSAIC MEDICAL (NPI# 1649681560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649681560 |
| Entity Type | Organization |
| Organization Name | MOSAIC MEDICAL |
| Other Organization Name | MOSAIC MEDICAL ENSWORTH SCHOOL BASED HEALTH CENTER |
| Practice Address |
2150 Ne Daggett Ln Bend OR 97701-6560 |
| Mailing Address |
600 Sw Columbia St Suite 6210 Bend OR 97702-1099 |
| Practice Telephone | 5413233850 |
| Practice Fax Number | 5413831883 |
| Mailing Telephone | 5413233181 |
| Mailing Fax Number | 5417069895 |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2016-04-19 |
| Authorized Official Name | MEGAN HAASE (CEO) |
| Authorized Official Telephone | 5414470707 |
| Authorized Official Credential | NP |
| Is Organization Subpart | Y |
| Parent Organization Name | MOSAIC MEDICAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | 182960 | 05 |
| Other Name | Type Code |
|---|---|
| Mosaic Medical Ensworth School Based Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467090183 | Mosaic Medical | Pharmacy | 375 Nw Beaver St Ste 103, Prineville, OR 97754-1802 | 2019-12-12 |
| 1124366570 | Mosaic Medical | Clinic/Center | 850 Sw 4th St, Suite 101, Madras, OR 97741-9628 | 2013-01-18 |
| 1205174653 | Mosaic Medical | Clinic/Center | 757 Ne 1st Street, Prineville, OR 97754-2003 | 2013-01-18 |
| 1083633184 | Mosaic Medical | Clinic/Center | 375 Nw Beaver Street, Suite 101, Prineville, OR 97754 | 2006-07-19 |
| 1184273757 | Mosaic Medical | Clinic/Center | 2965 Ne Conners Ave Ste 280, Bend, OR 97701-7753 | 2019-09-06 |
| 1992354567 | Mosaic Medical | Clinic/Center | 1250 Sw Veterans Way Ste 120, Redmond, OR 97756-2588 | 2019-09-06 |
| 1801445473 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2019-09-06 |
| 1457900011 | Mosaic Medical | Clinic/Center | 850 Sw 4th St Ste 101, Madras, OR 97741-9629 | 2019-09-06 |
| 1629627203 | Mosaic Medical | Clinic/Center | 375 Nw Beaver St Ste 101, Prineville, OR 97754-1802 | 2019-09-06 |
| 1528560091 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 S Main St, Maryville, MO 64468-2655 |
| Iowa Business Entities | MOSAIC MEDICAL CENTER - MARYVILLE | 2016 South Main, Maryville, MO 64468 |
| Oregon Corporations, Companies and Business Names | MOSAIC MEDICAL GROUP, LLC | 1290 Green Meadows Way, Ashland, OR 97520 |
| Colorado Business Entities | Mosaic Medical Massage, LLC | 1075 S. Yukon St., Unit 320, Lakewood, CO 80226 |
| Oregon Corporations, Companies and Business Names | MOSAIC MEDICAL PRODUCTS | 17300 Lake Haven Drive, Lake Oswego, OR 97035 |
| Oregon Corporations, Companies and Business Names | MOSAIC MEDICAL PRODUCTS LLC | 17300 Lake Haven Dr, Lake Oswego, OR 97035 |
| Street Address |
2150 NE DAGGETT LN |
| City | BEND |
| State | OR |
| Zip Code | 97701-6560 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255662953 | Elizabeth T Millan | Nurse Practitioner | 2150 Ne Daggett Ln, Bend, OR 97701-6560 | 2010-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104465525 | Andrew Kyle Burzynski | Denturist | 853 Ne 4th St., Bend, OR 97701 | 2020-01-02 |
| 1013480714 | Andrew Traut | Specialist/Technologist | Oregon State Force Lab, 2200 Ne Neff Rd Suite 202, Bend, OR 97701 | 2019-01-04 |
| 1871063917 | Calley Asbill, Nd LLC | Chiropractor | 2146 Ne 4th Street, Suite 160, Bend, OR 97701 | 2018-12-02 |
| 1902372212 | Carisa S Battin | Counselor | 361 Ne Franklin Avenue Bldg E #4, Bend, OR 97701 | 2018-10-15 |
| 1366921223 | Hillside Eye Center LLC | Ophthalmology | 625 Nw Colorado Avenue, Bend, OR 97701 | 2018-08-11 |
| 1528545514 | Kellie Michiko Kawasaki-jones | Dentist | 62968 Ob Riley Road, Suite 12, Bend, OR 97701 | 2018-07-23 |
| 1992255327 | Shelby Chiropractic | Chiropractor | 561 Ne Bellevue Dr Ste 102, Bend, OR 97701 | 2016-10-10 |
| 1144671520 | Kevin Richard Pett | Acupuncturist | 39 Nw Louisanna Ave., Hawthorn Healing Arts Center, Bend, OR 97701 | 2016-06-27 |
| 1912357500 | Sheldon Shawn Doveri | Driver | 233 Nw Revere Ave, Bend, OR 97701 | 2016-06-15 |
| 1740647411 | Anne Power | Homeopath | 2100 Ne Neff Rd Suite B, Bend, OR 97701 | 2016-01-26 |
| Find all providers in zip 97701 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184273757 | Mosaic Medical | Clinic/Center | 2965 Ne Conners Ave Ste 280, Bend, OR 97701-7753 | 2019-09-06 |
| 1801445473 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2019-09-06 |
| 1528560091 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2018-03-01 |
| 1023523073 | Mosaic Medical | Clinic/Center | 2577 Ne Courtney Dr Ste 100, Bend, OR 97701-7638 | 2017-12-12 |
| 1164820270 | Mosaic Medical | Clinic/Center | 230 Ne 6th St, Bend, OR 97701-5103 | 2014-12-05 |
| 1346656444 | Mosaic Medical | Clinic/Center | 1700 Se Tempest Dr, Bend, OR 97702-1884 | 2014-07-09 |
| 1215368329 | Mosaic Medical | Clinic/Center | 1128 Nw Harriman St, Bend, OR 97701-1947 | 2013-11-29 |
| 1710328992 | Mosaic Medical | Clinic/Center | 2965 Ne Conners Ave, Suite 280, Bend, OR 97701-7753 | 2013-07-16 |
| 1588902860 | Mosaic Medical Mobile Unit | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-01-22 |
| 1316285760 | Mosaic Medical | Clinic/Center | 2084 Ne Professional Ct, Bend, OR 97701-6077 | 2013-01-18 |
| Find all providers in BEND | ||||
Please comment or provide details below to improve the information on MOSAIC MEDICAL.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.