| Name: | Island Peer Review Organization, Inc. |
| Jurisdiction: | Rhode Island |
| Entity type: | Foreign Non-Profit Corporation |
| Status: | Activ |
| Date of Organization in Rhode Island: | 11 Sep 2012 (12 years ago) |
| Identification Number: | 000793048 |
| Principal Address: | 1979 MARCUS AVENUE, LAKE SUCCESS, NY, 11042, USA |
| Purpose: | CONDUCT INDEPENDENT EXTERNAL QUALITY REVIEWS OF PATIENTS FILES RELATED TO THE STATES MEDICAID PROGRAM AS AGREED TO BY THE STATE OF RHODE ISLAND AND PROVIDENCE PLANTATIONS |
| Name | Role | Address |
|---|---|---|
| REPUBLIC REGISTERED AGENT LLC | Agent | 50 INDUSTRIAL CIR #105, LINCOLN, RI, 02865, USA |
| Name | Role | Address |
|---|---|---|
| ROBERT J PANZER, MD | SECRETARY | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| THEODORE O WILL | CEO | 1979 MARCUS AVENUE LAKE SUCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| JOHN FRIEDMAN, MD | PRESIDENT | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| RAYMOND D SWEENEY | VICE PRESIDENT | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| ALAN WOGHIN | SR. VICE PRESIDENT & CFO | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| STUART ALMER | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| WILLIAM SHANAHAN | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| BARBARA BRECKENRIDGE | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| HEEKYEONG MA | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| RENITA L PECK | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| NAUMAN SHAHID, MD | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| BRUCE CHERNOF, MD | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| LOIS WAGH | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| NIESHA NEAL | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| PAUL F MACIELAK, ESQ | DIRECTOR | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| EDISON A MACHADO, MD | SR.VICE PRESIDENT & CSO | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| CLARE BRADLEY POLLET, MD | SR. VICE PRESIDENT & CMO | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| PAUL J ROWLAND | TREASURER | 1979 MARCUS AVENUE LAKE SUCCESS, NY 11042 USA |
| Name | Role | Address |
|---|---|---|
| HERMAN A JENICH | SR.VICE PRESIDENT & CDAO | 1979 MARCUS AVE, SUITE 105 LAKE SUCESS, NY 11042 USA |
| Number | Name | File Date |
|---|---|---|
| 202457766340 | Statement of Change of Registered/Resident Agent | 2024-07-09 |
| 202449624380 | Annual Report | 2024-03-27 |
| 202339857070 | Annual Report | 2023-07-28 |
| 202338488590 | Revocation Notice For Failure to File An Annual Report | 2023-06-20 |
| 202213059170 | Annual Report | 2022-03-18 |
| 202199158720 | Annual Report | 2021-07-08 |
| 202041501070 | Annual Report | 2020-06-04 |
| 201993859150 | Annual Report | 2019-05-22 |
| 201864190090 | Annual Report | 2018-05-08 |
| 201743447020 | Annual Report | 2017-05-23 |
Date of last update: 17 Oct 2024
Sources: Rhode Island Department of State
