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  5. Smithfield Pediatrics, Inc.

Smithfield Pediatrics, Inc.

Company Details

Name: Smithfield Pediatrics, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 21 Jul 1998 (27 years ago)
Identification Number: 000101623
ZIP code: 02828
County: Providence County
Principal Address: 7 SMITH AVENUE SUITE 103, SMITHFIELD, RI, 02828, USA
Purpose: TO ENGAGE IN THE PRACTICE OF MEDICINE
NAICS: 621111 - Offices of Physicians (except Mental Health Specialists)
Fictitious names: Smithfield Pediatrics (trading name, 1999-04-01 - 2013-02-08)
Historical names: STEPHANIE J. PENCHUK, M.D., INC.

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346411592 2008-03-16 2022-05-25 7 SMITH AVENUE, SUITE 103, GREENVILLE, RI, 02828, US 7 SMITH AVENUE, SUITE 103, GREENVILLE, RI, 02828, US

Contacts
Phone +1 401-231-3138
Fax 4012314757

Authorized person
Name JESSICA LYNCH
Role OFFICE MANAGER
Phone 4012313138

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SMITHFIELD PEDIATRICS INC 401(K) PROFIT SHARING PLAN & TRUST 2023 043431959 2024-05-06 SMITHFIELD PEDIATRICS INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012314757
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2024-05-06
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401(K) PROFIT SHARING PLAN & TRUST 2022 043431959 2023-04-10 SMITHFIELD PEDIATRICS INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012313138
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2023-04-10
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401(K) PROFIT SHARING PLAN & TRUST 2021 043431959 2022-04-28 SMITHFIELD PEDIATRICS INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012313138
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2022-04-28
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401(K) PROFIT SHARING PLAN & TRUST 2020 043431959 2021-04-06 SMITHFIELD PEDIATRICS INC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012313138
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2021-04-06
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401(K) PROFIT SHARING PLAN & TRUST 2019 043431959 2020-06-09 SMITHFIELD PEDIATRICS INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012313138
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2020-06-09
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401 K PROFIT SHARING PLAN TRUST 2018 043431959 2019-07-08 SMITHFIELD PEDIATRICS INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012313138
Plan sponsor’s address 7 SMITH AVE STE 103, GREENVILLE, RI, 028281700

Signature of
Role Plan administrator
Date 2019-07-08
Name of individual signing JESSICA LYNCH
Valid signature Filed with authorized/valid electronic signature
SMITHFIELD PEDIATRICS INC 401 K PROFIT SHARING PLAN TRUST 2017 043431959 2018-07-23 SMITHFIELD PEDIATRICS INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 812990
Sponsor’s telephone number 4012314757
Plan sponsor’s address 41 SANDERSON RD STE 202, SMITHFIELD, RI, 02917

Signature of
Role Plan administrator
Date 2018-07-23
Name of individual signing KATHLEEN LOUISE DEBLASIO
Valid signature Filed with authorized/valid electronic signature

Agent

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

PRESIDENT

Name Role Address
DINUSHA DIETRICH MD PRESIDENT 7 SMITH AVENUE, SUITE 103 GREENVILLE, RI 02828 USA

Events

Type Date Old Value New Value
Name Change 2013-02-08 STEPHANIE J. PENCHUK, M.D., INC. Smithfield Pediatrics, Inc.

Filings

Number Name File Date
202448309710 Annual Report 2024-03-08
202331984080 Annual Report 2023-03-29
202213669900 Annual Report 2022-03-24
202193500750 Annual Report 2021-03-01
202035168650 Annual Report 2020-02-24
201988612410 Annual Report 2019-03-13
201859819890 Annual Report 2018-03-05
201738088230 Annual Report 2017-03-13
201692896320 Annual Report 2016-02-22
201555823830 Annual Report 2015-02-26

Related by officers

STEPHEN D. ZUBIAGO, ESQ.

Nicholas A. Califano, M.D., Inc. CARDIOLOGY ASSOCIATES, INC. MIRIAM IPA, INC. ORTHOPEDIC GROUP, 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.

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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