| Name: | Robert A. Carrellas. M.D., Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Domestic Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 02 Jun 2003 (22 years ago) |
| Identification Number: | 000132416 |
| ZIP code: | 02842 |
| County: | Newport County |
| Principal Address: | 674 AQUIDNECK AVENUE, MIDDLETOWN, RI, 02842, USA |
| Purpose: | MEDICAL PRACTICE |
NAICS
621491 HMO Medical CentersThis U.S. industry comprises establishments with physicians and other medical staff primarily engaged in providing a range of outpatient medical services to the health maintenance organization (HMO) subscribers with a focus generally on primary health care. These establishments are owned by the HMO. Included in this industry are HMO establishments that both provide health care services and underwrite health and medical insurance policies. Learn more at the U.S. Census Bureau
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619079852 | 2006-09-01 | 2009-08-20 | 674 AQUIDNECK AVE, BUILDING A, UNIT 1, MIDDLETOWN, RI, 028425692, US | 674 AQUIDNECK AVE, BUILDING A, UNIT 1, MIDDLETOWN, RI, 028425692, US | |||||||||||||||||||||||||
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| Phone | +1 401-847-9955 |
| Fax | 4018479948 |
Authorized person
| Name | DR. ROBERT A CARRELLAS |
| Role | PRESIDENT |
| Phone | 4018479955 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 8200 |
| State | RI |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 7002857 |
| State | RI |
| Name | Role | Address |
|---|---|---|
| NEIL P. GALVIN | Agent | 10A WASHINGTON SQUARE, NEWPORT, RI, 02840, USA |
| Name | Role | Address |
|---|---|---|
| ROBERT ANTHONY CARRELLAS | PRESIDENT | 127 RIVERVIEW AVENUE MIDDLETOWN, RI 02842 UNI |
| ROBERT A CARRELLAS MD | PRESIDENT | 674 AQUIDNECK AVENUE MIDDLETOWN, RI 02842 USA |
| Name | Role | Address |
|---|---|---|
| ROBERT ANTHONY CARRELLAS MD | OTHER OFFICER | 127 RIVERVIEW AVE MIDDLETOWN, RI 02842 UNI |
| Number | Name | File Date |
|---|---|---|
| 202458622870 | Annual Report | 2024-08-07 |
| 202457158460 | Revocation Notice For Failure to File An Annual Report | 2024-06-25 |
| 202334355670 | Annual Report | 2023-04-27 |
| 202213515270 | Annual Report | 2022-03-27 |
| 202198744780 | Annual Report | 2021-06-28 |
| 202196817710 | Revocation Notice For Failure to File An Annual Report | 2021-05-19 |
| 202044204770 | Annual Report | 2020-07-05 |
| 201989683680 | Annual Report | 2019-04-01 |
| 201864549140 | Statement of Change of Registered/Resident Agent Office | 2018-05-10 |
| 201859756500 | Annual Report | 2018-03-05 |
Date of last update: 11 Apr 2025
Sources: Rhode Island Department of State
