NPIMap

Organization Active NPI

Manassas Primary Care, LLC

  • Primary Care Clinic/Center
  • Manassas, VA
National Provider Identifier
1972892065
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
0101240433 Issued in VA
Legal business name
MANASSAS PRIMARY CARE, LLC
Practice address
8428 Dorsey Cir
Suite 101
Manassas, VA 20110-8302
Phone
(571) 379-8827
Fax
(888) 224-4936
NPI assigned
Mar 29, 2011
Last updated
Sep 14, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Navdeep Mathur, MDNPI 1952346066
Title
Owner
Phone
(571) 379-8827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 0101240433 VA Primary

Addresses

Primary practice location

8428 Dorsey Cir
Suite 101
Manassas, VA 20110-8302

Mailing address

9913 Manet Rd
Burke, VA 22015-3806
Phone (703) 994-8845

Other identifiers 1

IdentifierTypeStateIssuer
1952346066OtherVAINDIVIDUAL NPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20111012000001 VA Part B Supplier - Clinic/Group Practice 7911179171 Receives reassigned benefits from 1 practitioner
Practice locations: Manassas, VA
O20111118000061 DC Part B Supplier - Clinic/Group Practice 7911179171 Receives reassigned benefits from 1 practitioner
Practice locations: Manassas, VA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2031354Manassas Primary Care LLC8428 Dorsey Circle - Suite 101, Manassas, VA 20110Certificate of waiverSep 25, 2026

National Provider Directory

National Provider Directory

Locations

8428 Dorsey Cir
Ste 101
Manassas, VA 20110
Phone (571) 379-8827

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1972892065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9913 MANET RD",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220153806",
            "telephone_number": "703-994-8845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8428 DORSEY CIR",
            "address_2": "SUITE 101",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "201108302",
            "telephone_number": "571-379-8827",
            "fax_number": "888-224-4936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANASSAS PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "MATHUR",
        "authorized_official_first_name": "NAVDEEP",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "571-379-8827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "VA",
            "license": "0101240433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1952346066",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.