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OPTIMUM CARE FAMILY MEDICINE, LLC

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Company Details

Name: OPTIMUM CARE FAMILY MEDICINE, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 18 Jun 2008 (17 years ago)
Entity Number: 3685822
ZIP code: 11787
County: Suffolk
Place of Formation: New York
Address: 321 EAST MAIN STREET, SUITE 1, SMITHTOWN, NY, United States, 11787

Contact Details

Phone +1 631-265-4606

DOS Process Agent

Name Role Address
OPTIMUM CARE FAMILY MEDICINE, LLC DOS Process Agent 321 EAST MAIN STREET, SUITE 1, SMITHTOWN, NY, United States, 11787

National Provider Identifier

NPI Number:
1134832116
Certification Date:
2023-10-18

Authorized Person:

Name:
DR. ANNA KAPSALIS-RAMBALAKOS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207QA0505X - Adult Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6312654675

Form 5500 Series

Employer Identification Number (EIN):
262870614
Plan Year:
2023
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
3
Sponsors Telephone Number:

History

Start date End date Type Value
2018-08-28 2024-06-14 Address 321 EAST MAIN STREET, SUITE 1, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)
2012-06-12 2018-08-28 Address 321 MIDDLE COUNTRY ROAD, SUITE 1, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)
2010-06-29 2012-06-12 Address NICHOLAS LIVRIERI, MD, 321 MIDDLE COUNTRY ROAD / #4, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)
2008-06-18 2010-06-29 Address NICHOLAS LIVRIERI, M.D., 321 MIDDLE COUNTRY RD STE 4, SMITHTOWN, NY, 11787, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240614001255 2024-06-14 BIENNIAL STATEMENT 2024-06-14
220622003625 2022-06-22 BIENNIAL STATEMENT 2022-06-01
200602060940 2020-06-02 BIENNIAL STATEMENT 2020-06-01
180828002027 2018-08-28 BIENNIAL STATEMENT 2018-06-01
120612006590 2012-06-12 BIENNIAL STATEMENT 2012-06-01

USAspending Awards / Financial Assistance

Date:
2021-01-30
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:
82200.00
Total Face Value Of Loan:
82200.00
Date:
2020-05-02
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:
61400.00
Total Face Value Of Loan:
61400.00

Paycheck Protection Program

Date Approved:
2021-01-30
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
82200
Current Approval Amount:
82200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
83467.25
Date Approved:
2020-05-02
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
61400
Current Approval Amount:
61400
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
62118.3

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State