| CASE NUMBER | I-200-24311-456487 |
| CASE STATUS | Certified |
| RECEIVED DATE | 11/6/2024 |
| DECISION DATE | 11/14/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Staff Physician - Block Hospitalist |
| SOC CODE | 29-1216 |
| SOC TITLE | General Internal Medicine Physicians |
| FULL TIME POSITION | Y |
| BEGIN DATE | 4/11/2025 |
| END DATE | 4/10/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 0 |
| AMENDED PETITION | 1 |
| EMPLOYER NAME | Trinity Health of New England Provider Network Organization, Inc. |
| TRADE NAME DBA | Trinity Health of New England Medical Group |
| EMPLOYER ADDRESS1 | 1000 Asylum Avenue |
| EMPLOYER ADDRESS2 | Floor 4 |
| EMPLOYER CITY | Hartford |
| EMPLOYER STATE | CT |
| EMPLOYER POSTAL CODE | 6105 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 18607144000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 622110 |
| EMPLOYER POC LAST NAME | Murphy |
| EMPLOYER POC FIRST NAME | Heidi |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | Provider Onboarding Consultant |
| EMPLOYER POC ADDRESS1 | 1000 Asylum Avenue |
| EMPLOYER POC ADDRESS2 | Floor 4 |
| EMPLOYER POC CITY | Hartford |
| EMPLOYER POC STATE | CT |
| EMPLOYER POC POSTAL CODE | 6105 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 18606396293 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | N/A |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Cross |
| AGENT ATTORNEY FIRST NAME | Jessica |
| AGENT ATTORNEY MIDDLE NAME | L. |
| AGENT ATTORNEY ADDRESS1 | 8529 Six Forks Road, Forum IV |
| AGENT ATTORNEY ADDRESS2 | Suite 600 |
| AGENT ATTORNEY CITY | Raleigh |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27615 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 19197879700 |
| AGENT ATTORNEY PHONE EXT | |
| AGENT ATTORNEY EMAIL ADDRESS | Rachel.Bradley@ogletreedeakins.com |
| LAWFIRM NAME BUSINESS NAME | Ogletree Deakins |
| STATE OF HIGHEST COURT | DC |
| NAME OF HIGHEST STATE COURT | District of Columbia Court of Appeals |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 114 Woodland Street |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Hartford |
| WORKSITE COUNTY | HARTFORD CITY |
| WORKSITE STATE | CT |
| WORKSITE POSTAL CODE | 6105 |
| WAGE RATE OF PAY FROM | $245,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $239,200.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | N/A |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 2 |
| AGREE TO LC STATEMENT | Yes |
| H 1B DEPENDENT | No |
| WILLFUL VIOLATOR | No |
| SUPPORT H1B | N/A |
| STATUTORY BASIS | |
| APPENDIX A ATTACHED | N/A |
| PUBLIC DISCLOSURE | Disclose Business |
| PREPARER LAST NAME | |
| PREPARER FIRST NAME | |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | |
| PREPARER EMAIL | |
| BEGIN DATE CONVERTED | 2025-04-11 |
