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  5. ORTHOPEDIC GROUP, INC.

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 (54 years ago)
Date of Dissolution: 18 Oct 2019 (5 years ago)
Date of Status Change: 18 Oct 2019 (5 years ago)
Identification Number: 000020530
ZIP code: 02860
County: Providence County
Principal Address: 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860, USA
Purpose: MEDICAL SERVICES
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)
Fictitious names: Blackstone Orthopedics & Sports Medicine (trading name, 2013-08-08 - )

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1629221817 2008-10-31 2008-10-31 6 BLACKSTONE VALLEY PL, STE. 530, LINCOLN, RI, 028651179, US 6 BLACKSTONE VALLEY PL, STE. 530, LINCOLN, RI, 028651179, US

Contacts
Phone +1 401-334-3700
Fax 4013343414

Authorized person
Name STEVEN BLAZAR
Role MANAGING PARTNER
Phone 4017222400

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2016 050342977 2017-11-13 ORTHOPEDIC GROUP, INC. 1
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2016 050342977 2017-10-02 ORTHOPEDIC GROUP, INC. 106
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2015 050342977 2016-09-02 ORTHOPEDIC GROUP, INC. 113
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2014 050342977 2015-09-28 ORTHOPEDIC GROUP, INC. 109
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2015-09-28
Name of individual signing STEVEN L. BLAZAR
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2013 050342977 2014-03-19 ORTHOPEDIC GROUP, INC. 99
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2014-03-19
Name of individual signing STEVEN BLAZAR
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2012 050342977 2013-04-11 ORTHOPEDIC GROUP, INC. 99
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Signature of
Role Plan administrator
Date 2013-04-11
Name of individual signing PHILIP W. RHOADES
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2011 050342977 2012-05-22 ORTHOPEDIC GROUP, INC. 108
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621399
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Plan administrator’s name and address
Administrator’s EIN 050342977
Plan administrator’s name ORTHOPEDIC GROUP, INC.
Plan administrator’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017222400

Signature of
Role Plan administrator
Date 2012-05-22
Name of individual signing PHILIP W. RHOADES
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2010 050342977 2011-09-30 ORTHOPEDIC GROUP, INC. 111
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Plan administrator’s name and address
Administrator’s EIN 050342977
Plan administrator’s name ORTHOPEDIC GROUP, INC.
Plan administrator’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017222400

Signature of
Role Plan administrator
Date 2011-09-30
Name of individual signing PHILIP W. RHOADES
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2009 050342977 2010-07-27 ORTHOPEDIC GROUP, INC. 108
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Plan administrator’s name and address
Administrator’s EIN 050342977
Plan administrator’s name ORTHOPEDIC GROUP, INC.
Plan administrator’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017222400

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing PHILIP W. RHOADES
Valid signature Filed with authorized/valid electronic signature
ORTHOPEDIC GROUP, INC. EMPLOYEE PROFIT SHARING PLAN 2009 050342977 2010-07-23 ORTHOPEDIC GROUP, INC. 108
Three-digit plan number (PN) 002
Effective date of plan 1988-10-01
Business code 621111
Sponsor’s telephone number 4017222400
Plan sponsor’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860

Plan administrator’s name and address
Administrator’s EIN 050342977
Plan administrator’s name ORTHOPEDIC GROUP, INC.
Plan administrator’s address 588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860
Administrator’s telephone number 4017222400

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

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
201587714100 Annual Report 2015-11-10
201578251850 Revocation Notice For Failure to File An Annual Report 2015-09-08
201436178530 Statement of Change of Registered/Resident Agent 2014-02-25
201331940160 Annual Report 2013-12-18
201326693460 Fictitious Business Name Statement 2013-08-08

Related by officers

STEPHEN D. ZUBIAGO, ESQ.

Nicholas A. Califano, M.D., Inc. CARDIOLOGY ASSOCIATES, INC. MIRIAM IPA, INC. Bayside Endoscopy Group, Inc. Mobile Storage Inc. H & H TRUCKING INC. MIRIAM PHO, INC. Bayside OB-GYN, Inc. West Bay Orthopaedics and Neurosurgery, Inc. Cornerstone Financial Group, Inc.

Related by address

588 PAWTUCKET AVENUE, PAWTUCKET, RI, 02860, USA

Nursing Placement, Inc. The Nursing Placement Foundation NURSING PLACEMENT HOME HEALTH CARE SERVICES, INC. Neurosurgery Associates, Inc. NORTH MAIN LAFAYETTE REALTY, LLC BIGNEY & BARROS PROPERTIES, LLC BIGNEY & BARROS INVESTMENTS, LLC ORTHOPEDIC URGENT CARE, LLC Nursing Placement Hospice & Palliative Care, LLC

Date of last update: 06 Oct 2024

Sources: Rhode Island Department of State

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