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  5. PRIMARY CARE OF SHELTON, LLC

PRIMARY CARE OF SHELTON, LLC

Company Details

Entity Name: PRIMARY CARE OF SHELTON, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Active
Sub status: Annual report due
Date Formed: 06 Feb 2007
Business ALEI: 0887815
Annual report due: 31 Mar 2025
NAICS code: 621111 - Offices of Physicians (except Mental Health Specialists)
Business address: 555 BRIDGEPORT AVE 2ND FLOOR 2ND FLOOR, SHELTON, CT, 06484, United States
Mailing address: 555 BRIDGEPORT AVE., SHELTON, CT, United States, 06484
ZIP code: 06484
County: Fairfield
Place of Formation: CONNECTICUT
E-Mail: bardia.asgari@pcofshelton.net

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2023 364601949 2024-07-31 PRIMARY CARE OF SHELTON LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE, SHELTON, CT, 06484

Signature of
Role Plan administrator
Date 2024-07-31
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2022 364601949 2023-08-08 PRIMARY CARE OF SHELTON LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2023-08-08
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2021 364601949 2022-09-16 PRIMARY CARE OF SHELTON LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2022-09-16
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2020 364601949 2021-06-07 PRIMARY CARE OF SHELTON LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2021-06-07
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2019 364601949 2020-06-26 PRIMARY CARE OF SHELTON LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2020-06-26
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2018 364601949 2019-06-14 PRIMARY CARE OF SHELTON LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2019-06-14
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2017 364601949 2018-10-05 PRIMARY CARE OF SHELTON LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2018-10-05
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2016 364601949 2017-07-06 PRIMARY CARE OF SHELTON LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2015 364601949 2016-08-25 PRIMARY CARE OF SHELTON LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2016-08-25
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature
PRIMARY CARE OF SHELTON LLC 401(K) P/S PLAN 2014 364601949 2015-04-09 PRIMARY CARE OF SHELTON LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 2032250506
Plan sponsor’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484

Plan administrator’s name and address
Administrator’s EIN 364601949
Plan administrator’s name PRIMARY CARE OF SHELTON LLC
Plan administrator’s address 555 BRIDGEPORT AVE., SHELTON, CT, 06484
Administrator’s telephone number 2032250506

Signature of
Role Plan administrator
Date 2015-04-09
Name of individual signing BARDIA ASGARI
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Mailing address Phone E-Mail Residence address
BARDIA ASGARI MD Agent 555 BRIDGEPORT AVE., SHELTON, CT, 06484, United States 555 BRIDGEPORT AVE., SHELTON, CT, 06484, United States +1 203-556-7672 bardia.asgari@pcofshelton.net 120 CRANBURY DR., TRUMBULL, CT, 06611, United States

Officer

Name Role Business address Residence address
BARDIA ASGARI Officer 555 BRIDGEPORT AVE, 2ND FLOOR, SHELTON, CT, 06484, United States 120 CRANBURY DR, TRUMBULL, CT, 06611, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
BF-0012042341 2024-02-19 No data Annual Report Annual Report No data
BF-0009449668 2023-03-14 No data Annual Report Annual Report 2020
BF-0009449656 2023-03-14 No data Annual Report Annual Report 2019
BF-0009449634 2023-03-14 No data Annual Report Annual Report 2018
BF-0009963948 2023-03-14 No data Annual Report Annual Report No data
BF-0010871444 2023-03-14 No data Annual Report Annual Report No data
BF-0011416792 2023-03-14 No data Annual Report Annual Report No data
0005769458 2017-02-16 No data Annual Report Annual Report 2014
0005769470 2017-02-16 No data Annual Report Annual Report 2017
0005769466 2017-02-16 No data Annual Report Annual Report 2016

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 13 Jan 2025

Sources: Connecticut's Official State Website

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