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  5. Pediatric Ophthalmology and Strabismus Associates, Inc.

Pediatric Ophthalmology and Strabismus Associates, Inc.

Company Details

Name: Pediatric Ophthalmology and Strabismus Associates, Inc.
Jurisdiction: Rhode Island
Entity type: Domestic Profit Corporation
Status: Activ
Date of Organization in Rhode Island: 23 Jun 2000 (25 years ago)
Identification Number: 000113151
ZIP code: 02905
County: Providence County
Principal Address: 2 DUDLEY STREET SUITE 505, PROVIDENCE, RI, 02905, USA
Purpose: TO PROVIDE PEDIATRIC OPHTHALMOLOGY SERVICES TO PATIENTS
NAICS: 621320 - Offices of Optometrists

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578678777 2006-08-20 2023-05-30 2 DUDLEY ST, SUITE 505, PROVIDENCE, RI, 029053236, US 2 DUDLEY ST, SUITE 505, PROVIDENCE, RI, 029053236, US

Contacts
Phone +1 401-444-7008
Fax 4014444862

Authorized person
Name TANYA ALVES
Role PRACTICE MANAGER
Phone 4014447008

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number RI7784
State RI
Is Primary No
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
POS RETIREMENT PLAN 2023 050512251 2024-04-10 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2024-04-10
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2022 050512251 2023-03-31 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2023-03-31
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2021 050512251 2022-07-25 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2022-07-25
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2020 050512251 2021-03-17 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2021-03-17
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2019 050512251 2020-04-16 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2020-04-16
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2018 050512251 2019-05-03 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2019-05-03
Name of individual signing DR. DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2017 050512251 2018-04-10 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2018-04-10
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2016 050512251 2017-10-01 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2017-10-01
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2015 050512251 2016-09-01 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2016-09-01
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
POS RETIREMENT PLAN 2014 050512251 2015-04-06 PEDIATRIC OPHTHALMOLOGY AND STRABISMUS ASSOCIATES, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2015-04-06
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/10/20140610081304P040135843669001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Signature of
Role Plan administrator
Date 2014-06-10
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/04/09/20130409074614P040059812581001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 050512251
Plan administrator’s name PEDIATRIC OPTHALMOLOGY AND STRABISMUS ASSOCIATES, INC.
Plan administrator’s address 2 DUDLEY STREET, PROVIDENCE, RI, 029053236
Administrator’s telephone number 4014447008

Signature of
Role Plan administrator
Date 2013-04-09
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/07/19/20120719080505P040007198866001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2001-01-01
Business code 621111
Sponsor’s telephone number 4014447008
Plan sponsor’s address 2 DUDLEY STREET, SUITE 505, PROVIDENCE, RI, 02905

Plan administrator’s name and address
Administrator’s EIN 050512251
Plan administrator’s name PEDIATRIC OPTHALMOLOGY AND STRABISMUS ASSOCIATES, INC.
Plan administrator’s address 2 DUDLEY STREET, PROVIDENCE, RI, 029053236
Administrator’s telephone number 4014447008

Signature of
Role Plan administrator
Date 2012-07-19
Name of individual signing DAVID TIEN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
JOHN W. WOLFE, ESQ. Agent 301 PROMENADE STREET, PROVIDENCE, RI, 02908, USA

DIRECTOR, PRESIDENT

Name Role Address
DAVID ROBBINS TIEN M.D. DIRECTOR, PRESIDENT 2 DUDLEY STREET, SUITE 505 PROVIDENCE, RI 02905 USA

DIRECTOR

Name Role Address
TINEKE CHAN M.D. DIRECTOR 2 DUDLEY STREET, SUITE 505 PROVIDENCE, RI 02905 USA

Filings

Number Name File Date
202454556250 Annual Report 2024-05-20
202330928760 Annual Report 2023-03-15
202221219780 Annual Report 2022-07-13
202220056250 Revocation Notice For Failure to File An Annual Report 2022-06-27
202208072230 Statement of Change of Registered/Resident Agent 2022-01-18
202190103800 Annual Report 2021-02-05
202036619250 Annual Report 2020-03-20
201985080690 Annual Report 2019-01-24
201985080320 Statement of Change of Registered/Resident Agent Office 2019-01-24
201857235610 Annual Report 2018-02-01

Related by officers

JOHN W. WOLFE, ESQ.

GTS FLEXIBLE MATERIALS, INC. BROWN NEUROLOGY DIAGNOSTIC INFORMATION SYSTEM, INC. Frank J. Jehle, Jr., M.D., Inc. AAD, LLC AMERICAN FRIENDS OF THE HAKLUYT SOCIETY SEASCAPE LAWN CARE INC. Bungo.com, Inc. Wakefield Printing Corp. S. LOME AND SONS JEWELERS, 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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