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  5. UNIVERSITY PEDIATRICS, INC.

UNIVERSITY PEDIATRICS, INC.

Company Details

Name: UNIVERSITY PEDIATRICS, INC.
Jurisdiction: Rhode Island
Entity type: Professional Service Corporation
Status: Revoked Entity
Date of Organization in Rhode Island: 18 Aug 1998 (27 years ago)
Date of Dissolution: 15 Nov 2018 (6 years ago)
Date of Status Change: 15 Nov 2018 (6 years ago)
Identification Number: 000102102
ZIP code: 02906
County: Providence County
Principal Address: 100 HIGHLAND AVENUE SUITE 302, PROVIDENCE, RI, 02906, USA
Purpose: TO PROVIDE PROFESSIONAL MEDICAL SERVICES.

Industry & Business Activity

NAICS

62 Health Care and Social Assistance

The Sector as a Whole Learn more at the U.S. Census Bureau

Companies doing Health care and social assistance

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1932117702 2006-08-04 2014-03-27 100 HIGHLAND AVE, SUITE 201, PROVIDENCE, RI, 029062740, US 100 HIGHLAND AVE, SUITE 201, PROVIDENCE, RI, 029062740, US

Contacts
Phone +1 401-633-1100
Fax 4016330047

Authorized person
Name ROBERT E EDEN
Role OWNER
Phone 4016331100

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
State RI
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number UP29391
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2019 050500549 2020-10-15 UNIVERSITY PEDIATRICS INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing ROBERT EDEN
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2018 050500549 2019-10-15 UNIVERSITY PEDIATRICS INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing ROBERT EDEN
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2017 050500549 2018-10-15 UNIVERSITY PEDIATRICS INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing ROBERT EDEN
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2016 050500549 2017-10-16 UNIVERSITY PEDIATRICS INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing LETITIA VELLECA
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2015 050500549 2016-10-17 UNIVERSITY PEDIATRICS INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2014 050500549 2015-10-26 UNIVERSITY PEDIATRICS INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2015-10-26
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2013 050500549 2014-10-08 UNIVERSITY PEDIATRICS INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Signature of
Role Plan administrator
Date 2014-10-08
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2012 050500549 2013-07-29 UNIVERSITY PEDIATRICS INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Plan administrator’s name and address
Administrator’s EIN 050500549
Plan administrator’s name UNIVERSITY PEDIATRICS INC.
Plan administrator’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906
Administrator’s telephone number 4016331100

Signature of
Role Plan administrator
Date 2013-07-29
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2011 050500549 2012-10-01 UNIVERSITY PEDIATRICS INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Plan administrator’s name and address
Administrator’s EIN 050500549
Plan administrator’s name UNIVERSITY PEDIATRICS INC.
Plan administrator’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906
Administrator’s telephone number 4016331100

Signature of
Role Plan administrator
Date 2012-10-01
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
UNIVERSITY PEDIATRICS INC. 401(K) PLAN 2010 050500549 2011-10-12 UNIVERSITY PEDIATRICS INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Plan administrator’s name and address
Administrator’s EIN 050500549
Plan administrator’s name UNIVERSITY PEDIATRICS INC.
Plan administrator’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906
Administrator’s telephone number 4016331100

Signature of
Role Plan administrator
Date 2011-10-12
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/13/20101013075700P040009126466001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 4016331100
Plan sponsor’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906

Plan administrator’s name and address
Administrator’s EIN 050500549
Plan administrator’s name UNIVERSITY PEDIATRICS INC.
Plan administrator’s address 100 HIGHLAND AVENUE, SUITE 201, PROVIDENCE, RI, 02906
Administrator’s telephone number 4016331100

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing ROBYN PERROTTI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JEFFREY F. CHASE-LUBITZ, ESQ. Agent DONOGHUE BARRETT & SINGAL P.C. ONE CEDAR STREET SUITE 300, PROVIDENCE, RI, 02903, USA

PRESIDENT

Name Role Address
ROBERT E. EDEN, M.D. PRESIDENT 100 HIGHLAND AVENUE, SUITE 302 PROVIDENCE, RI 02906 USA

Filings

Number Name File Date
201881219770 Revocation Certificate For Failure to File the Annual Report for the Year 2018-11-15
201875473810 Revocation Notice For Failure to File An Annual Report 2018-08-24
201737745620 Annual Report 2017-03-07
201695362480 Annual Report 2016-03-29
201561855300 Statement of Change of Registered Office by the Registered Agent 2015-05-20
201452503150 Annual Report 2014-12-29
201432310240 Annual Report 2014-01-02
201311810900 Annual Report 2013-02-15
201288569810 Annual Report 2012-01-26
201176592210 Annual Report 2011-03-14

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
3395606009 Small Business Administration 59.012 - 7(A) LOAN GUARANTEES No data No data TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE
Recipient UNIVERSITY PEDIATRICS
Recipient Name Raw UNIVERSITY PEDIATRICS
Recipient DUNS 009039046
Recipient Address 100 HIGHLAND AVE STE 201, PROVIDENCE, PROVIDENCE, RHODE ISLAND, 29060-0000, UNITED STATES
Obligated Amount 0.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 115000.00
Link View Page

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5905767105 2020-04-14 0165 PPP 100 Highland Ave, PROVIDENCE, RI, 02906
Loan Status Date 2021-06-30
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 118250
Loan Approval Amount (current) 118250
Undisbursed Amount 0
Franchise Name -
Lender Location ID 29805
Servicing Lender Name TD Bank, National Association
Servicing Lender Address 2035 Limestone Rd, WILMINGTON, DE, 19808-5529
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Unanswered
Project Address PROVIDENCE, PROVIDENCE, RI, 02906-0003
Project Congressional District RI-01
Number of Employees 7
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 29805
Originating Lender Name TD Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 119452.21
Forgiveness Paid Date 2021-04-22

Related by officers

JEFFREY F. CHASE-LUBITZ, ESQ.

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Related by address

No related companies by address

Date of last update: 09 Apr 2025

Sources: Rhode Island Department of State

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