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  5. Coastal Eye Associates, Inc.

Coastal Eye Associates, Inc.

Company Details

Name: Coastal Eye Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Activ
Date of Organization in Rhode Island: 02 Jul 1996 (29 years ago)
Identification Number: 000090289
ZIP code: 02891
County: Washington County
Principal Address: 17 WELLS STREET SUITE 101, WESTERLY, RI, 02891, USA
Purpose: THE PRACTICE OF OPTOMETRY.
NAICS: 621320 - Offices of Optometrists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1174601132 2006-11-01 2024-09-10 17 WELLS ST, STE 101, WESTERLY, RI, 028912923, US 17 WELLS ST, STE 101, WESTERLY, RI, 028912923, US

Contacts
Phone +1 401-348-2020
Fax 4015969348

Authorized person
Name HOLLY MISTO
Role OWNER
Phone 4013482020

Taxonomy
Taxonomy Code 152W00000X - Optometrist
State RI
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number CE00626
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2023 050492668 2024-06-12 COASTAL EYE ASSOCIATES 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2024-06-12
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-06-12
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2022 050492668 2023-04-14 COASTAL EYE ASSOCIATES 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2023-04-14
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-04-14
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2021 050492668 2022-04-11 COASTAL EYE ASSOCIATES 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2022-04-11
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-04-11
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2020 050492668 2021-04-21 COASTAL EYE ASSOCIATES 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2021-04-21
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-21
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2019 050458112 2020-03-06 COASTAL EYE ASSOCIATES 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2020-03-06
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-03-06
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2018 050458112 2019-04-08 COASTAL EYE ASSOCIATES 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2019-04-08
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-04-08
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2017 050458112 2018-03-27 COASTAL EYE ASSOCIATES 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2018-03-27
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-03-27
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2016 050458112 2017-05-08 COASTAL EYE ASSOCIATES 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2017-05-08
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-05-08
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2015 050458112 2016-08-11 COASTAL EYE ASSOCIATES 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2016-08-11
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-08-11
Name of individual signing HOLLY MISTO
Valid signature Filed with authorized/valid electronic signature
COASTAL EYE ASSOCIATES PROFIT SHARING PLAN 2014 050458112 2015-06-22 COASTAL EYE ASSOCIATES 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2015-06-22
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-22
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/13/20140613092644P030130082101001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2014-06-13
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-13
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/04/25/20130425090234P040188878467001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-04-25
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-25
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Signature of
Role Plan administrator
Date 2013-03-18
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-18
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/03/16/20120316092445P030235578128001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050458112
Plan administrator’s name COASTAL EYE ASSOCIATES
Plan administrator’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891
Administrator’s telephone number 4013482020

Signature of
Role Plan administrator
Date 2012-03-16
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-16
Name of individual signing RONALD SERRA
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050458112
Plan administrator’s name COASTAL EYE ASSOCIATES
Plan administrator’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891
Administrator’s telephone number 4013482020

Signature of
Role Plan administrator
Date 2011-03-14
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-14
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/03/15/20110315090440P040119799840001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050458112
Plan administrator’s name COASTAL EYE ASSOCIATES
Plan administrator’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891
Administrator’s telephone number 4013482020

Signature of
Role Plan administrator
Date 2011-03-15
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-03-15
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/17/20100817085047P070000661845001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621320
Sponsor’s telephone number 4013482020
Plan sponsor’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891

Plan administrator’s name and address
Administrator’s EIN 050458112
Plan administrator’s name COASTAL EYE ASSOCIATES
Plan administrator’s address 17 WELLS STREET, SUITE 101, WESTERLY, RI, 02891
Administrator’s telephone number 4013482020

Signature of
Role Plan administrator
Date 2010-08-17
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-17
Name of individual signing RONALD J SERRA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DANIEL J. URSO, CPA Agent 75 GRANITE STREET, WESTERLY, RI, 02891, USA

PRESIDENT

Name Role Address
HOLLY MISTO PRESIDENT P.O. BOX 117 WESTERLY, RI 02891 USA

Filings

Number Name File Date
202455276300 Annual Report 2024-05-30
202334812100 Annual Report 2023-04-28
202217274470 Annual Report 2022-05-09
202193448430 Annual Report 2021-03-02
202036976740 Annual Report 2020-03-30
201989690570 Annual Report 2019-04-01
201856236690 Annual Report 2018-01-16
201733702690 Annual Report 2017-02-06
201690898920 Annual Report 2016-01-19
201578500200 Annual Report - Amended 2015-09-08

Related by officers

DANIEL J. URSO, CPA

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Related by address

No related companies by address

Date of last update: 08 Oct 2024

Sources: Rhode Island Department of State

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