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  5. JOHN M. SIMON, M.D., P.C.

JOHN M. SIMON, M.D., P.C.

Company Details

Name: JOHN M. SIMON, M.D., P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 22 Jul 1988 (37 years ago)
Entity Number: 1279353
ZIP code: 11706
County: Suffolk
Place of Formation: New York
Address: 270 EAST MAIN STREET, BAY SHORE, NY, United States, 11706

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2016 112910248 2017-10-23 JOHN M. SIMON, M.D., P.C. 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2016 112910248 2017-10-12 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2015 112910248 2016-10-14 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2015 112910248 2016-10-14 JOHN M. SIMON, M.D., P.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2014 112910248 2015-10-15 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2014 112910248 2015-07-28 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2013 112910248 2014-09-02 JOHN M. SIMON, M.D., P.C. 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-09-02
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2013 112910248 2014-04-11 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6313216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-04-11
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. 401(K) PLAN 2012 112910248 2014-04-10 JOHN M. SIMON, M.D., P.C. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 6213216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2014-04-10
Name of individual signing CHRISTOPHER MARADIE
JOHN M. SIMON, M.D., P.C. CASH BALANCE PLAN 2012 112910248 2013-10-14 JOHN M. SIMON, M.D., P.C. 0
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 6213216801
Plan sponsor’s address 580 UNION BOULEVARD, WEST ISLIP, NY, 11795

Signature of
Role Plan administrator
Date 2013-10-14
Name of individual signing CHRISTOPHER MARADIE

DOS Process Agent

Name Role Address
JOHN M. SIMON, PHYSICIAN, P.C. DOS Process Agent 270 EAST MAIN STREET, BAY SHORE, NY, United States, 11706

Filings

Filing Number Date Filed Type Effective Date
080728000789 2008-07-28 CERTIFICATE OF AMENDMENT 2008-07-28
B665979-4 1988-07-22 CERTIFICATE OF INCORPORATION 1988-07-22

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4265527208 2020-04-27 0235 PPP 580 UNION BLVD, WEST ISLIP, NY, 11795
Loan Status Date 2021-04-23
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 25000
Loan Approval Amount (current) 25000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WEST ISLIP, SUFFOLK, NY, 11795-0001
Project Congressional District NY-02
Number of Employees 1
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 194093
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address CHICAGO, IL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 25219.82
Forgiveness Paid Date 2021-03-18
7235138502 2021-03-05 0235 PPS 580 Union Blvd, West Islip, NY, 11795-3105
Loan Status Date 2021-11-19
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 20832
Loan Approval Amount (current) 20832
Undisbursed Amount 0
Franchise Name -
Lender Location ID 48270
Servicing Lender Name JPMorgan Chase Bank, National Association
Servicing Lender Address 1111 Polaris Pkwy, COLUMBUS, OH, 43240-2031
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address West Islip, SUFFOLK, NY, 11795-3105
Project Congressional District NY-02
Number of Employees 1
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 48270
Originating Lender Name JPMorgan Chase Bank, National Association
Originating Lender Address COLUMBUS, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 20947.69
Forgiveness Paid Date 2021-09-29

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Date of last update: 16 Mar 2025

Sources: New York Secretary of State

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