MOONSTONE MENTAL HEALTH
NPI 1083450761
Nurse Practitioner - Psychiatric/Mental Health in Tigard, OR
About Moonstone Mental Health NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MOONSTONE MENTAL HEALTH (NPI 1083450761) is a healthcare organization registered as a psychiatric/mental health in Tigard, Oregon and active in the NPI registry since July 2024. The organization lists Jennie Peterson, Pmhnp-bc, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Moonstone Mental Health is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Moonstone Mental Health, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Moonstone Mental Health's NPI number?
The NPI number for Moonstone Mental Health is 1083450761. It was assigned to this organization in the NPPES registry on July 2, 2024.
Where is Moonstone Mental Health located?
Moonstone Mental Health is located at 7110 SW Fir Loop Ste 145, Tigard, OR 97223. The listed phone number is (503) 389-5882.
What is Moonstone Mental Health's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Moonstone Mental Health enrolled in Medicare?
Yes. Moonstone Mental Health is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Moonstone Mental Health?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Moonstone Mental Health. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Moonstone Mental Health accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc. and Regence BlueCross BlueShield of Oregon list Moonstone Mental Health as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Moonstone Mental Health was last updated on January 20, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Moonstone Mental Health · NPI 1083450761
Psychiatric/Mental Health organization in Tigard, Oregon. Organization record, active in the CMS NPPES registry since July 2, 2024.
## Identity
- **NPI:** 1083450761 (Entity type: Organization)
- **Enumerated:** July 2, 2024
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Jennie Peterson, PMHNP-BC
## Practice location
- **Address:** 7110 SW FIR LOOP STE 145, Tigard, OR 97223-8031
- **Phone:** (503) 389-5882
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Nurse Practitioner) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 20, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1083450761) · Data from the CMS NPPES public registry.