| Name: | Rhode Island Cardiovascular Group, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 20 Apr 2001 (24 years ago) |
| Identification Number: | 000118036 |
| ZIP code: | 02865 |
| County: | Providence County |
| Principal Address: | 6 BLACKSTONE VALLEY PL STE 105, LINCOLN, RI, 02865, USA |
| Purpose: | TO RENDER PROFESSIONAL MEDICAL SERVICES AND CONSULTATION. TO ENGAGE IN THE LICENSED PRACTICE OF MEDICINE AND CARDIOLOGY. |
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
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568495232 | 2006-07-08 | 2008-06-16 | 68 CUMBERLAND ST, SUITE 103, WOONSOCKET, RI, 028953323, US | 68 CUMBERLAND ST, SUITE 103, WOONSOCKET, RI, 028953323, US | |||||||||||||||||||||||
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| Phone | +1 401-762-3838 |
| Fax | 4017628252 |
Authorized person
| Name | KIRIT DESAI |
| Role | PRESIDENT |
| Phone | 4017623838 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | RI37476 |
| State | RI |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RHODE ISLAND CARDIOVASCULAR GROUP, INC. 401(K)PLAN | 2009 | 050517130 | 2010-10-15 | RHODE ISLAND CARDIOVASCULAR GROUP, INC. | 39 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 050517130 |
| Plan administrator’s name | RHODE ISLAND CARDIOVASCULAR GROUP, INC. |
| Plan administrator’s address | 68 CUMBERLAND STREET, WOONSOCKET, RI, 028953323 |
| Administrator’s telephone number | 4017623838 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-15 |
| Name of individual signing | DAVID BADER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| STEPHEN D. ZUBIAGO, ESQ. | Agent | NIXON PEABODY LLP ONE CITIZENS PLAZA SUITE 500, PROVIDENCE, RI, 02903, USA |
| Name | Role | Address |
|---|---|---|
| JOSEPH P MAZZA MD | PRESIDENT | 6 BLACKSTONE VALLEY PL STE 105 LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| JOSEPH P MAZZA MD | TREASURER | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| JOSEPH P MAZZA MD | SECRETARY | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| SIJID SIDDIQ MD | VICE PRESIDENT | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| Name | Role | Address |
|---|---|---|
| JOSEPH P MAZZA MD | DIRECTOR | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| SAJID SIDDIQ MD | DIRECTOR | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| THOMAS LANNA MD | DIRECTOR | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| N. CHRISTOPHER KELLEY MD | DIRECTOR | 6 BLACKSTONE VALLEY PL, STE. 105 LINCOLN, RI 02865 USA |
| A. RITA PETER-FAHERTY MD | DIRECTOR | 68 CUMBERLAND ST., STE. 103 WOONSOCKET, RI 02895 USA |
| GEORGE BOURGANOS MD | DIRECTOR | 68 CUMBERLAND ST. STE. 103 WOONSOCKET, RI 02895 USA |
| Number | Name | File Date |
|---|---|---|
| 202449086700 | Annual Report | 2024-03-13 |
| 202334191610 | Annual Report | 2023-04-25 |
| 202214036800 | Annual Report | 2022-03-28 |
| 202193261750 | Annual Report | 2021-02-25 |
| 202036232260 | Annual Report | 2020-03-11 |
| 201989227370 | Annual Report | 2019-03-25 |
| 201861123370 | Annual Report | 2018-03-28 |
| 201734989810 | Annual Report | 2017-02-27 |
| 201694762650 | Annual Report | 2016-03-16 |
| 201556127270 | Annual Report | 2015-03-02 |
Date of last update: 10 Apr 2025
Sources: Rhode Island Department of State
