| Name: | University Surgical Associates, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 19 Dec 1980 (44 years ago) |
| Identification Number: | 000028437 |
| ZIP code: | 02916 |
| County: | Providence County |
| Principal Address: | 75 NEWMAN AVENUE, RUMFORD, RI, 02916, USA |
| Purpose: | TO ENGAGE IN MEDICAL RESEARCH IN CONJUNCTION WITH HOSPITALS ASSOCIATED WITH BROWN UNIVERSITY SCHOOL OF MEDICINE |
| Fictitious names: |
Brown Surgical Associates (trading name, 2020-01-02 - ) |
| Historical names: |
RIH Surgery Foundation, Inc. |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376589895 | 2006-06-22 | 2021-03-23 | PO BOX 16149, RUMFORD, RI, 029160697, US | 2 DUDLEY ST STE 470, PROVIDENCE, RI, 029053248, US | |||||||||||||||||||||||||
|
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| Phone | +1 401-453-9625 |
| Fax | 4014357069 |
| Phone | +1 401-272-1800 |
| Fax | 4017515124 |
Authorized person
| Name | MRS. AMY D HICKEY |
| Role | DIRECTOR, FINANCIAL OPERATIONS |
| Phone | 4018542444 |
Taxonomy
| Taxonomy Code | 208600000X - Surgery Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | RI04030 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY | Agent | 222 JEFFERSON BOULEVARD SUITE 200, WARWICK, RI, 02888, USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN MIGLIORI | TREASURER | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| Name | Role | Address |
|---|---|---|
| JEFFREY SLAIBY MD | SECRETARY | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| Name | Role | Address |
|---|---|---|
| WILLIAM CIOFFI MD | PRESIDENT | 593 EDDY STREET PROVIDENCE, RI 02905- USA |
| Name | Role | Address |
|---|---|---|
| STEPHEN J MIGLIORI MD | VICE PRESIDENT | 2 DUDLEY STREET, STE 470 PROVIDNCE, RI 02905 USA |
| Name | Role | Address |
|---|---|---|
| DAVID CLOUTIER MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| FRANCOIS LUKS MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02904 USA |
| CHARU TANEJA MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02904 USA |
| STEPHANIE LUECKEL MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| DAVID HARRINGTON MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| JEFFREY SLAIBY MD | DIRECTOR | 2 DUDLEY STREET, STE 470 PROVIDENCE, RI 02905 USA |
| MATTHEW VREES | DIRECTOR | 195 COLLYER STREET PROVIDENCE, RI 02904 USA |
| Type | Date | Old Value | New Value |
|---|---|---|---|
| Name Change | 1994-04-12 | RIH Surgery Foundation, Inc. | University Surgical Associates, Inc. |
| Number | Name | File Date |
|---|---|---|
| 202448454140 | Annual Report | 2024-03-13 |
| 202327585130 | Annual Report | 2023-02-06 |
| 202209002380 | Annual Report | 2022-02-01 |
| 202197884090 | Annual Report | 2021-06-07 |
| 202042406590 | Annual Report | 2020-06-17 |
| 202030994010 | Fictitious Business Name Statement | 2020-01-02 |
| 201903132340 | Annual Report | 2019-07-10 |
| 201870172600 | Annual Report | 2018-06-21 |
| 201745784420 | Annual Report | 2017-06-19 |
| 201601174930 | Annual Report | 2016-06-29 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEFINITIVE CONTRACT | AWARD | 36C24124C0011 | 2024-01-01 | 2028-12-31 | 2028-12-31 | |||||||||||||||||||||||||
|
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| Obligated Amount | 70648.00 |
| Current Award Amount | 70648.00 |
| Potential Award Amount | 375092.15 |
Description
| Title | THORACIC PHYSICIAN SERVICES |
| NAICS Code | 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS |
| Product and Service Codes | Q524: CARDIOTHORACIC SURGERY |
Recipient Details
| Recipient | UNIVERSITY SURGICAL ASSOCIATES INC |
| UEI | M167ELCGE5A7 |
| Recipient Address | UNITED STATES, 75 NEWMAN AVE, RUMFORD, PROVIDENCE, RHODE ISLAND, 029163606 |
| Unique Award Key | CONT_AWD_36C24120C0001_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Award Amounts
| Obligated Amount | 718880.55 |
| Current Award Amount | 718880.55 |
| Potential Award Amount | 718880.55 |
Description
| Title | VASCULAR PHYSICIAN SERVICES FOR PROVIDENCE VAMC |
| NAICS Code | 611310: COLLEGES, UNIVERSITIES, AND PROFESSIONAL SCHOOLS |
| Product and Service Codes | Q523: MEDICAL- SURGERY |
Recipient Details
| Recipient | UNIVERSITY SURGICAL ASSOCIATES INC |
| UEI | M167ELCGE5A7 |
| Recipient Address | UNITED STATES, 75 NEWMAN AVE STE 200, RUMFORD, PROVIDENCE, RHODE ISLAND, 029161945 |
Date of last update: 06 Oct 2024
Sources: Rhode Island Department of State
