| CASE NUMBER | I-200-25029-651969 |
| CASE STATUS | Certified |
| RECEIVED DATE | 1/29/2025 |
| DECISION DATE | 2/5/2025 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Nurse Practitioner |
| SOC CODE | 29-1171.00 |
| SOC TITLE | Nurse Practitioners |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/29/2025 |
| END DATE | 1/28/2028 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| EMPLOYER NAME | Rajiv Siddaramu MD PLLC |
| TRADE NAME DBA | BluPeak Health |
| EMPLOYER ADDRESS1 | 3219 E Camelback Rd |
| EMPLOYER ADDRESS2 | Suite 224 |
| EMPLOYER CITY | Phoenix |
| EMPLOYER STATE | AZ |
| EMPLOYER POSTAL CODE | 85018 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 16027538120 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 6211 |
| EMPLOYER POC LAST NAME | SIDDARAMU |
| EMPLOYER POC FIRST NAME | RAJIV |
| EMPLOYER POC MIDDLE NAME | |
| EMPLOYER POC JOB TITLE | CEO/MD |
| EMPLOYER POC ADDRESS1 | 3219 E CAMELBACK RD |
| EMPLOYER POC ADDRESS2 | SUITE 224 |
| EMPLOYER POC CITY | PHOENIX |
| EMPLOYER POC STATE | AZ |
| EMPLOYER POC POSTAL CODE | 85018 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 16027538120 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | rajiv.s@bluepeakhealth.com |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | WEISBERG |
| AGENT ATTORNEY FIRST NAME | JEFFREY |
| AGENT ATTORNEY MIDDLE NAME | A |
| AGENT ATTORNEY ADDRESS1 | 32871 MIDDLEBELT ROAD |
| AGENT ATTORNEY ADDRESS2 | SUITE 100 |
| AGENT ATTORNEY CITY | FARMINGTON HILLS |
| AGENT ATTORNEY STATE | MI |
| AGENT ATTORNEY POSTAL CODE | 48334 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | |
| AGENT ATTORNEY PHONE | 12489320630 |
| AGENT ATTORNEY PHONE EXT | 230 |
| AGENT ATTORNEY EMAIL ADDRESS | H1B@GOWDA.COM |
| LAWFIRM NAME BUSINESS NAME | LAW OFFICES OF AMARNATH GOWDA |
| STATE OF HIGHEST COURT | MI |
| NAME OF HIGHEST STATE COURT | SUPREME COURT |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 4742 N 24TH ST |
| WORKSITE ADDRESS2 | STE # 300 |
| WORKSITE CITY | PHOENIX |
| WORKSITE COUNTY | MARICOPA |
| WORKSITE STATE | AZ |
| WORKSITE POSTAL CODE | 85016 |
| WAGE RATE OF PAY FROM | $117,146.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | $117,146.01 |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $117,146.00 |
| PW UNIT OF PAY | Year |
| PW TRACKING NUMBER | |
| PW WAGE LEVEL | II |
| PW OES YEAR | 7/1/2024 - 6/30/2025 |
| PW OTHER SOURCE | |
| PW OTHER YEAR | |
| PW SURVEY PUBLISHER | |
| PW SURVEY NAME | |
| TOTAL WORKSITE LOCATIONS | 1 |
| 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 | MOTURU |
| PREPARER FIRST NAME | MRUDULA |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | LAW OFFICES OF AMARNATH GOWDA |
| PREPARER EMAIL | h1b@gowda.com |
| BEGIN DATE CONVERTED | 2025-01-29 |
