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ORTHOPEDIC GROUP, INC.

Company Details

Name: ORTHOPEDIC GROUP, INC.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 01 Dec 1970 (55 years ago)
Date of Dissolution: 18 Oct 2019 (6 years ago)
Date of Status Change: 18 Oct 2019 (6 years ago)
Identification Number: 000020530
ZIP code: 02860
County: Providence County
Purpose: MEDICAL SERVICES
Fictitious names: Blackstone Orthopedics & Sports Medicine (trading name, 2013-08-08 - )
Principal Address: Google Maps Logo 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860, USA

Industry & Business Activity

NAICS

621111 Offices of Physicians (except Mental Health Specialists)

This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau

Agent

Name Role Address
STEPHEN D. ZUBIAGO, ESQ. Agent NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA

TREASURER

Name Role Address
DAVID J. CICERCHIA MD TREASURER 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA

SECRETARY

Name Role Address
STEVEN N. GRAFF MD SECRETARY 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA

PRESIDENT

Name Role Address
STEVEN L BLAZAR MD PRESIDENT 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA

DIRECTOR

Name Role Address
STEVEN N. GRAFF MD DIRECTOR 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA
JONATHAN A. GASTEL MD DIRECTOR 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA
ERIC F. WALSH MD DIRECTOR 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA
STEVEN L. BLAZAR MD DIRECTOR 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA
DAVID J. CICERCHIA MD DIRECTOR 588 PAWTUCKET AVENUE PAWTUCKET, RI 02860 USA

National Provider Identifier

NPI Number:
1629221817

Authorized Person:

Name:
STEVEN BLAZAR
Role:
MANAGING PARTNER
Phone:

Taxonomy:

Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
4013343414

Form 5500 Series

Employer Identification Number (EIN):
050342977
Plan Year:
2016
Number Of Participants:
1
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
106
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
113
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
109
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
99
Sponsors Telephone Number:

Filings

Number Name File Date
201924545170 Revocation Certificate For Failure to File the Annual Report for the Year 2019-10-18
201906961550 Revocation Notice For Failure to File An Annual Report 2019-07-24
201860281170 Annual Report 2018-03-14
201738088050 Annual Report 2017-03-13
201690108380 Annual Report 2016-01-06

Date of last update: 17 May 2025

Sources: Rhode Island Department of State