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HEADLIGHT MENTAL HEALTHCARE LLC
NPI 1265242820
Nurse Practitioner - Psychiatric/Mental Health in Portland, OR

Active since January 07, 2025
555 SE MLK BLVD UNIT 105, PORTLAND, OR 97214(541) 581-1080(541) 588-6525 Get Directions Write a Review

NPPES record last updated: August 24, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 24, 2026, Jan 7, 2025 (2 updates tracked since 2025).

About Headlight Mental Healthcare Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

HEADLIGHT MENTAL HEALTHCARE LLC (NPI 1265242820) is a healthcare organization registered as a psychiatric/mental health in Portland, Oregon and active in the NPI registry since January 2025. The organization lists Matthew Dean Laird, Owner, as its authorized official.

NPPES Registry Identity

NPI1265242820
Entity TypeOrganization
Primary Taxonomy363LP0808X
Legal Business NameHEADLIGHT MENTAL HEALTHCARE LLC
Location Address555 SE MLK BLVD UNIT 105Portland, OR 97214-2595
Mailing Address555 Se Mlk Blvd Ste 105Portland, OR 97214-2595 · (541) 581-1080 · Fax (541) 588-6525
Phone(541) 581-1080
Fax(541) 588-6525
Organization SubpartNo
Authorized OfficialMatthew Dean LairdOwner · (541) 581-1080
Enumeration DateJanuary 7, 2025
Last NPPES UpdateAugust 24, 20262 updates tracked since enumeration
NPPES CertifiedAugust 24, 2026
✔ NPI 1265242820 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
555 SE MLK BLVD UNIT 105, Portland, OR 97214
Open in Google Maps ↗

Other Identifiers 2

Other10003860OR · Oregon State Board Of Nursing
Other231782392OR · Business Registry Number

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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)

Headlight Mental Healthcare Llc 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 Headlight Mental Healthcare LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Matthew Laird, PMHNP-BC
Nurse Practitioner
NPI 1619683224
2 N CENTRAL AVE STE 1800
Phoenix, AZ 85004
(480) 618-7023
✔ PECOS1,019 mi

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 Headlight Mental Healthcare LLC's NPI number?

The NPI number for Headlight Mental Healthcare LLC is 1265242820. It was assigned to this organization in the NPPES registry on January 7, 2025.

Where is Headlight Mental Healthcare LLC located?

Headlight Mental Healthcare LLC is located at 555 SE Mlk Blvd Unit 105, Portland, OR 97214. The listed phone number is (541) 581-1080.

What is Headlight Mental Healthcare LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Headlight Mental Healthcare LLC enrolled in Medicare?

Yes. Headlight Mental Healthcare LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Headlight Mental Healthcare LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Nurse Practitioner) reassigns their Medicare billing to Headlight Mental Healthcare LLC. 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 Headlight Mental Healthcare LLC accept?

Health plans from Moda Health Plan, Inc. list Headlight Mental Healthcare LLC 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 Headlight Mental Healthcare LLC was last updated on August 24, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.