OrganizationActive
Mosaic Medical
NPI 1629627203 · Federally Qualified Health Center (FQHC) · Prineville, OR
Provider details
- NPI number
- 1629627203
- Entity type
- Organization
- Primary specialty
- Federally Qualified Health Center (FQHC)Ambulatory Health Care Facilities
- Parent organization
- Mosaic Medical
- Organization subpart
- Yes
- Authorized official
- Bobbi Surplus, Revenue Cycle Manager(541) 408-9486
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(65/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
375 Nw Beaver St Ste 101
Prineville, OR 97754-1802
Phone: (541) 408-9486
Fax: (541) 647-2793
Street-level locationGet directions
Mailing address
600 Sw Columbia St Ste 6210
Bend, OR 97702-1099
Registry dates
- Enumerated
- 2019-09-06
- Last updated
- 2019-09-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.