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  5. Advanced Radiology, Inc.

Advanced Radiology, Inc.

Company Details

Name: Advanced Radiology, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 04 Jun 1999 (26 years ago)
Identification Number: 000106744
ZIP code: 02864
County: Providence County
Principal Address: 525 BROAD STREET, CUMBERLAND, RI, 02864, USA
Purpose: TO ENGAGE IN THE BUSINESS OF RADIOLOGICAL AND OTHER MEDICALSERVICES.
NAICS: 621512 - Diagnostic Imaging Centers

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1780638494 2006-05-19 2020-08-22 525 BROAD ST, CUMBERLAND, RI, 028646919, US 525 BROAD ST, CUMBERLAND, RI, 028646919, US

Contacts
Phone +1 401-727-4600
Fax 4017274690

Authorized person
Name JOHN S TKACH
Role ADMINISTRATOR
Phone 4017256736

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 7006349
State RI

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED RADIOLOGY 401(K) PLAN 2023 050505603 2024-06-19 ADVANCED RADIOLOGY, INC. 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2024-06-19
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2022 050505603 2023-05-15 ADVANCED RADIOLOGY, INC. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2023-05-15
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2021 050505603 2022-09-08 ADVANCED RADIOLOGY, INC. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2022-09-08
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2020 050505603 2021-04-28 ADVANCED RADIOLOGY, INC. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2021-04-28
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2019 050505603 2020-05-28 ADVANCED RADIOLOGY, INC. 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2020-05-28
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2018 050505603 2019-07-17 ADVANCED RADIOLOGY, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2019-07-17
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2017 050505603 2018-06-14 ADVANCED RADIOLOGY, INC. 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2018-06-14
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2016 050505603 2017-07-05 ADVANCED RADIOLOGY, INC. 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature
ADVANCED RADIOLOGY 401(K) PLAN 2015 050505603 2016-06-13 ADVANCED RADIOLOGY, INC. 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621510
Sponsor’s telephone number 4017274600
Plan sponsor’s address 525 BROAD STREET, CUMBERLAND, RI, 02864

Signature of
Role Plan administrator
Date 2016-06-13
Name of individual signing KRISHANU GUPTA
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
ROMAN A. KLUFAS, MD Agent 525 BROAD STREET, CUMBERLAND, RI, 02864, USA

PRESIDENT

Name Role Address
ROMAN A KLUFAS MD PRESIDENT 50 GALEN COURT SEEKONK, MA 02771 USA

Filings

Number Name File Date
202447654910 Annual Report 2024-03-01
202328870370 Annual Report 2023-02-20
202211700290 Annual Report 2022-02-27
202190409010 Annual Report 2021-02-08
202036017650 Annual Report 2020-03-08
201988174530 Annual Report 2019-03-06
201859417960 Annual Report 2018-02-28
201737279260 Annual Report 2017-03-03
201693292130 Annual Report 2016-02-28
201557900980 Annual Report 2015-03-22

Related by officers

ROMAN A KLUFAS MD

Open MRI of New England, 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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