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  5. Nephrology Associates, Inc.

Nephrology Associates, Inc.

Company Details

Name: Nephrology Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 01 Oct 1973 (51 years ago)
Date of Dissolution: 12 Oct 2022 (2 years ago)
Date of Status Change: 12 Oct 2022 (2 years ago)
Identification Number: 000014772
ZIP code: 02914
County: Providence County
Principal Address: 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA
Purpose: MEDICAL SERVICES
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1366426801 2005-11-29 2009-11-10 318 WATERMAN AVE, EAST PROVIDENCE, RI, 02914, US 318 WATERMAN AVE, EAST PROVIDENCE, RI, 029143525, US

Contacts
Phone +1 401-438-5950
Fax 4014352561

Authorized person
Name JOSEPH A CHAZAN
Role PRESIDENT
Phone 4014385950

Taxonomy
Taxonomy Code 207RN0300X - Nephrology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 0025539
State RI
Issuer NPI
Number 1366426801
Issuer MEDICAID
Number 9765972
State MA
Issuer MEDICAID
Number 110069682B
State MA
Issuer BLUE CROSS
Number 255
State RI
Issuer MEDICAID
Number 9736352
State MA
Issuer BLUE CROSS
Number M13329
State MA
Issuer MEDICAID
Number 110069682A
State RI
Issuer BLUE CROSS
Number M15273
State MA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2022 050352774 2023-08-16 NEPHROLOGY ASSOCIATES, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2021 050352774 2022-12-29 NEPHROLOGY ASSOCIATES, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2020 050352774 2022-03-01 NEPHROLOGY ASSOCIATES, INC. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2019 050352774 2020-12-22 NEPHROLOGY ASSOCIATES, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2018 050352774 2020-01-31 NEPHROLOGY ASSOCIATES, INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2017 050352774 2019-01-30 NEPHROLOGY ASSOCIATES, INC. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2016 050352774 2017-11-30 NEPHROLOGY ASSOCIATES, INC. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2015 050352774 2016-11-22 NEPHROLOGY ASSOCIATES, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2014 050352774 2016-03-18 NEPHROLOGY ASSOCIATES, INC. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950
NEPHROLOGY ASSOCIATES, INC. 401K PROFIT SHARING PLAN 2013 050352774 2015-04-02 NEPHROLOGY ASSOCIATES, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950

Signature of
Role Plan administrator
Date 2015-04-02
Name of individual signing JOSEPH CHAZAN, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/12/20140612120932P040439913569001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950

Signature of
Role Plan administrator
Date 2014-06-12
Name of individual signing JOSEPH CHAZAN, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/27/20130627145758P030098495013001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950

Signature of
Role Plan administrator
Date 2013-06-27
Name of individual signing JOSEPH CHAZAN, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/16/20120716114129P030005453714001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950

Signature of
Role Plan administrator
Date 2012-07-16
Name of individual signing JOSEPH CHAZAN, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/07/11/20110711133333P040013849570001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1974-02-01
Business code 621111
Sponsor’s telephone number 4014385950
Plan sponsor’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129

Plan administrator’s name and address
Administrator’s EIN 050352774
Plan administrator’s name NEPHROLOGY ASSOCIATES, INC.
Plan administrator’s address 318 WATERMAN AVENUE, PROVIDENCE, RI, 029065129
Administrator’s telephone number 4014385950

Signature of
Role Plan administrator
Date 2011-07-11
Name of individual signing JOSEPH CHAZAN, M.D.
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JOSEPH A. CHAZAN Agent 318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA

PRESIDENT

Name Role Address
MICHAEL A THURSBY PRESIDENT 66 LAURIE LANE NORTH ATTLEBORO, MA 02760 USA

VICE PRESIDENT

Name Role Address
CHRISTOPHER J COSGROVE VICE PRESIDENT 164 OVERLOOK DRIVE WARWICK, RI 02818 USA
DANIEL L DRAGOMIRE VICE PRESIDENT 7 GRANDVIEW AVENUE LINCOLN, RI 02865 USA

CHAIRMAN OF THE BOARD

Name Role Address
JOSEPH A CHAZAN CHAIRMAN OF THE BOARD 290 BLACKSTONE BLVD PROVIDENCE, RI 02906 USA

Filings

Number Name File Date
202223870420 Revocation Certificate For Failure to File the Annual Report for the Year 2022-10-12
202219987710 Revocation Notice For Failure to File An Annual Report 2022-06-27
202192487610 Annual Report 2021-02-22
202034166800 Annual Report 2020-02-10
201984092720 Annual Report 2019-01-09
201859275290 Annual Report 2018-02-26
201731069010 Annual Report 2017-01-27
201690700610 Annual Report 2016-01-14
201552773480 Annual Report 2015-01-06
201432490960 Annual Report 2014-01-07

Related by officers

JOSEPH A. CHAZAN

Preventive Medicine Associates, Inc. ARA-TIVERTON DIALYSIS LLC ARA-PAWTUCKET DIALYSIS LLC DIALYSIS CENTER OF WESTERLY LLC The Chazan Family Private Foundation CASSIS CONFECTIONS, LLC

JOSEPH A CHAZAN

AAD, INC. JAC EAST PROVIDENCE REALTY, LLC

Related by address

318 WATERMAN AVENUE, EAST PROVIDENCE, RI, 02914, USA

Patient Assistance Fund, Inc. Preventive Medicine Associates, Inc. Dialysis Centers of Rhode Island, Inc. DIALYSIS CENTERS OF RHODE ISLAND II, LLC

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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