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02904
Providence Surgical Care Group, Incorporated

Providence Surgical Care Group, Incorporated

Company Details

Name:	Providence Surgical Care Group, Incorporated
Jurisdiction:	Rhode Island
Entity type:	Domestic Profit Corporation
Status:	Dissolved
Date of Organization in Rhode Island:	06 Dec 1999 (25 years ago)
Date of Dissolution:	31 Dec 2024 (4 months ago)
Date of Status Change:	31 Dec 2024 (4 months ago)
Identification Number:	000109539
ZIP code:	02904
County:	Providence County
Principal Address:	486 SILVER SPRING ST, PROVIDENCE, RI, 02904-1556, USA
Purpose:	TO ENGAGE IN THE PRACTICE OF PROVIDING MEDICAL AND SURGICAL SERVICES.

Industry & Business Activity

NAICS

621111 Offices of Physicians (except Mental Health Specialists)

This U.S. industry comprises establishments of health practitioners having the degree of M.D. (Doctor of Medicine) or D.O. (Doctor of Osteopathy) primarily engaged in the independent practice of general or specialized medicine (except psychiatry or psychoanalysis) or surgery. These practitioners operate private or group practices in their own offices (e.g., centers, clinics) or in the facilities of others, such as hospitals or HMO medical centers. Learn more at the U.S. Census Bureau

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1437232543

2006-10-23

2011-12-23

486 SILVER SPRING ST, PROVIDENCE, RI, 029041556, US

Contacts

Phone	+1 401-454-0690
Fax	4014544281

Authorized person

Name	MR. ROBERT B PATTERSON
Role	PRESIDENT
Phone	4014540690

Taxonomy

Taxonomy Code	2086S0129X - Vascular Surgery Physician
Is Primary	Yes
Taxonomy Code	208G00000X - Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Is Primary	No

Other Provider Identifiers

Issuer	MEDICAID
Number	PS32025
State	RI

Agent

Name	Role	Address
ROBERT PATTERSON, MD	Agent	486 SILVER SPRING STREET, PROVIDENCE, RI, 02904, USA

TREASURER

Name	Role	Address
ROBERT B PATTERSON MD	TREASURER	486 SILVER SPRING STREET PROVIDENCE, RI 02904 USA

SECRETARY

Name	Role	Address
ROBERT B PATTERSON MD	SECRETARY	486 SILVER SPRING STREET PROVIDENCE, RI 02904 USA

PRESIDENT

Name	Role	Address
ROBERT B PATTERSON MD	PRESIDENT	486 SILVER SPRING STREET PROVIDENCE, RI 02904 USA

VICE PRESIDENT

Name	Role	Address
ROBERT B PATTERSON MD	VICE PRESIDENT	486 SILVER SPRING STREET PROVIDENCE, RI 02904 USA

OTHER OFFICER

Name	Role	Address
ROBERT B PATTERSON	OTHER OFFICER	486 SILVER SPRING ST PROVIDENCE, RI 02904-1556 USA

DIRECTOR

Name	Role	Address
ROBERT B PATTERSON MD	DIRECTOR	486 SILVER SPRING STREET PROVIDENCE, RI 02904 USA

Filings

Number	Name	File Date
202445870970	Annual Report	2024-02-04
202327483490	Annual Report	2023-02-03
202218298150	Annual Report	2022-06-05
202185919210	Annual Report	2021-01-12
202033025090	Annual Report	2020-01-26
201985631630	Annual Report	2019-01-31
201860186060	Annual Report	2018-03-14
201750790450	Annual Report	2017-10-02
201747756380	Revocation Notice For Failure to File An Annual Report	2017-07-27
201589361960	Annual Report	2015-12-17
201451109290	Annual Report	2014-12-11
201435638170	Annual Report	2014-02-17
201310883040	Annual Report	2013-02-04
201187342280	Annual Report	2011-12-28
201180144700	Annual Report	2011-06-14
201180144890	Annual Report	2011-06-14
201180144610	Reinstatement	2011-06-14
201072042710	Revocation Certificate For Failure to File the Annual Report for the Year	2010-11-09
201064214640	Statement of Change of Registered/Resident Agent	2010-06-24
201063164630	Revocation Notice For Failure to File An Annual Report	2010-06-16

Paycheck Protection Program

Loan Number

Loan Funded Date

SBA Origination Office Code

Loan Delivery Method

Borrower Street Address

3804097107

2020-04-12

0165

PPP

486 Silver Spring Street, PROVIDENCE, RI, 02904-1500

Loan Status Date	2021-04-21
Loan Status	Paid in Full
Loan Maturity in Months	24
SBA Guaranty Percentage	100
Loan Approval Amount (at origination)	73245
Loan Approval Amount (current)	73245
Undisbursed Amount	0
Franchise Name	-
Lender Location ID	15940
Servicing Lender Name	Webster Bank National Association
Servicing Lender Address	137 Bank St, WATERBURY, CT, 06702-2205
Rural or Urban Indicator	U
Hubzone	Y
LMI	N
Business Age Description	Existing or more than 2 years old
Project Address	PROVIDENCE, PROVIDENCE, RI, 02904-1500
Project Congressional District	RI-01
Number of Employees	5
NAICS code	622110
Borrower Race	White
Borrower Ethnicity	Not Hispanic or Latino
Business Type	Corporation
Originating Lender ID	15940
Originating Lender Name	Webster Bank National Association
Originating Lender Address	WATERBURY, CT
Gender	Male Owned
Veteran	Veteran
Forgiveness Amount	73927.28
Forgiveness Paid Date	2021-03-31

Date of last update: 10 Apr 2025

Sources: Rhode Island Department of State