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MOSAIC MEDICAL
NPI 1629627203
Clinic/Center - Federally Qualified Health Center (FQHC) in Prineville, OR

Active since September 06, 2019
375 NW BEAVER ST STE 101, PRINEVILLE, OR 97754(541) 408-9486(541) 647-2793 Get Directions Write a Review

NPPES record last updated: September 6, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mosaic Medical NPPES

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

MOSAIC MEDICAL (NPI 1629627203) is a healthcare organization registered as a federally qualified health center (fqhc) in Prineville, Oregon and active in the NPI registry since September 2019. The organization lists Bobbi Jolyne Surplus, Revenue Cycle Manager, as its authorized official.

NPPES Registry Identity

NPI1629627203
Entity TypeOrganization
Primary Taxonomy261QF0400X
Legal Business NameMOSAIC MEDICAL
Location Address375 NW BEAVER ST STE 101Prineville, OR 97754-1802
Mailing Address600 Sw Columbia St Ste 6210Bend, OR 97702-1099 · (541) 408-9486 · Fax (541) 647-2793
Phone(541) 408-9486
Fax(541) 647-2793
Organization SubpartYes
Authorized OfficialBobbi Jolyne SurplusRevenue Cycle Manager · (541) 408-9486
Enumeration DateSeptember 6, 2019
✔ NPI 1629627203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
Taxonomy Code261QF0400X
375 NW BEAVER ST STE 101, Prineville, OR 97754
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Other Providers at the Same Location NPPES 15

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SUZANNE M JONES FNP
Nurse Practitioner
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
ABIGAIL WIRTHLIN FNP
Nurse Practitioner (Family)
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005
CARMEN PETERS
Interpreter
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005
MARK THIBERT MD
Internal Medicine
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005
MRS. DIANA M BURDEN CFNP
Nurse Practitioner (Family)
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 447-0707
SARAH DENIECE KERSHNER NP
Nurse Practitioner (Gerontology)
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005
JESSICA LYNN ZACHEM CALDWELL
Nurse Practitioner (Family)
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005
ELVA LOPEZ
Community Health Worker
375 NW BEAVER ST STE 101
PRINEVILLE, OR 97754
Crook County (541) 383-3005

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 Mosaic Medical's NPI number?

The NPI number for Mosaic Medical is 1629627203. It was assigned to this organization in the NPPES registry on September 6, 2019.

Where is Mosaic Medical located?

Mosaic Medical is located at 375 NW Beaver St Ste 101, Prineville, OR 97754. The listed phone number is (541) 408-9486.

What is Mosaic Medical's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.

When was this NPI record last updated?

The NPPES record for Mosaic Medical was last updated on September 6, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.