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  5. SAMARITAN MEDICAL PRACTICE, P.C.

SAMARITAN MEDICAL PRACTICE, P.C.

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Company Details

Name: SAMARITAN MEDICAL PRACTICE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 29 Nov 2007 (18 years ago)
Entity Number: 3599219
ZIP code: 13601
County: Jefferson
Place of Formation: New York
Address: 830 WASHINGTON STREET, WATERTOWN, NY, United States, 13601
Principal Address: 830 WASHINGTON ST, WATERTOWN, NY, United States, 13601

Contact Details

Phone +1 315-782-1505

Phone +1 315-755-3650

Phone +1 315-779-6784

Phone +1 315-786-2000

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
MARIO VICTORIA MD Chief Executive Officer 830 WASHINGTON ST, WATERTOWN, NY, United States, 13601

DOS Process Agent

Name Role Address
C/O SAMARITAN MEDICAL CENTER, INC., ATTN: PRESIDENT DOS Process Agent 830 WASHINGTON STREET, WATERTOWN, NY, United States, 13601

National Provider Identifier

NPI Number:
1124202619
Certification Date:
2022-11-21
Link:
View on NPI website

Authorized Person:

Name:
MARIO VICTORIA
Role:
PRESIDENT
Phone:
3157854570

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Phone:
+1 315-785-4570
Phone:
+1 315-788-1751

History

Start date End date Type Value
2025-04-29 2025-05-15 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-03-29 2025-04-29 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2024-03-11 2024-03-29 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2011-12-06 2013-12-06 Address 830 WASHINGTON ST, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)
2009-11-19 2011-12-06 Address 830 WASHINGTON ST, WATERTOWN, NY, 13601, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
131206002030 2013-12-06 BIENNIAL STATEMENT 2013-11-01
111206002448 2011-12-06 BIENNIAL STATEMENT 2011-11-01
091119002162 2009-11-19 BIENNIAL STATEMENT 2009-11-01
071129000880 2007-11-29 CERTIFICATE OF INCORPORATION 2007-11-29

USAspending Awards / Financial Assistance

Date:
2020-05-20
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
-1129130.00
Total Face Value Of Loan:
0.00
Date:
2020-04-28
Link:
View on USAspending
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
1129130.00
Total Face Value Of Loan:
1129130.00

Tax Exempt

Employer Identification Number (EIN) :
26-1528342
In Care Of Name:
% SPENCER P FALCON MD
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2011-05
National Taxonomy Of Exempt Entities:
Health Care: Health Treatment Facilities, Primarily Outpatient
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

Link:
Download file
Link:
Download file

Paycheck Protection Program

Jobs Reported:
90
Initial Approval Amount:
$1,129,130
Date Approved:
2021-05-18
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,129,130
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,134,729.25
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $1,129,128
Utilities: $1
Jobs Reported:
90
Initial Approval Amount:
$1,129,130
Date Approved:
2020-04-27
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$1,129,130
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$1,144,968.76
Servicing Lender:
KeyBank National Association
Use of Proceeds:
Payroll: $1,129,130

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State

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