OrganizationActive
Old Town Manassas Medical Center
NPI 1184027161 · Clinic/Center · Manassas, VA
Provider details
- NPI number
- 1184027161
- Entity type
- Organization
- Primary specialty
- Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Flaviano Dazo, Owner(703) 365-0397
- License
- 0663198-0 (VA)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(75/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 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
9003 Church St
Manassas, VA 20110-5410
Phone: (703) 365-0397
Fax: (703) 365-0399
Street-level locationGet directions
Mailing address
9003 Church St
Manassas, VA 20110-5410
Registry dates
- Enumerated
- 2014-10-03
- Last updated
- 2014-10-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.