| CASE NUMBER | I-200-24270-367723 |
| CASE STATUS | Certified |
| RECEIVED DATE | 9/26/2024 |
| DECISION DATE | 10/3/2024 |
| ORIGINAL CERT DATE | |
| VISA CLASS | H-1B |
| JOB TITLE | Geriatrician |
| SOC CODE | 29-1229.00 |
| SOC TITLE | Physicians, All Other |
| FULL TIME POSITION | Y |
| BEGIN DATE | 1/6/2025 |
| END DATE | 1/5/2028 |
| 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 | MedStar Medical Group II, LLC |
| TRADE NAME DBA | MedStar Medical Group |
| EMPLOYER ADDRESS1 | 10980 Grantchester Way |
| EMPLOYER ADDRESS2 | |
| EMPLOYER CITY | Columbia |
| EMPLOYER STATE | MD |
| EMPLOYER POSTAL CODE | 21044 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PROVINCE | |
| EMPLOYER PHONE | 14105743000 |
| EMPLOYER PHONE EXT | |
| NAICS CODE | 62211 |
| EMPLOYER POC LAST NAME | Davidson |
| EMPLOYER POC FIRST NAME | Elissa |
| EMPLOYER POC MIDDLE NAME | D |
| EMPLOYER POC JOB TITLE | Senior Director, Physician Recruitment & Onboarding, MMG |
| EMPLOYER POC ADDRESS1 | 10980 Grantchester Way |
| EMPLOYER POC ADDRESS2 | |
| EMPLOYER POC CITY | Columbia |
| EMPLOYER POC STATE | MD |
| EMPLOYER POC POSTAL CODE | 21044 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PROVINCE | |
| EMPLOYER POC PHONE | 14105743000 |
| EMPLOYER POC PHONE EXT | |
| EMPLOYER POC EMAIL | elissa.d.davidson@medstar.net |
| AGENT REPRESENTING EMPLOYER | Yes |
| AGENT ATTORNEY LAST NAME | Read IV |
| AGENT ATTORNEY FIRST NAME | Forrest |
| AGENT ATTORNEY MIDDLE NAME | |
| AGENT ATTORNEY ADDRESS1 | 3737 GLENWOOD AVENUE |
| AGENT ATTORNEY ADDRESS2 | SUITE 450 |
| AGENT ATTORNEY CITY | RALEIGH |
| AGENT ATTORNEY STATE | NC |
| AGENT ATTORNEY POSTAL CODE | 27612 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PROVINCE | NORTH CAROLINA |
| AGENT ATTORNEY PHONE | 19197606460 |
| AGENT ATTORNEY PHONE EXT | 6468 |
| AGENT ATTORNEY EMAIL ADDRESS | FORREST.READ@JACKSONLEWIS.COM |
| LAWFIRM NAME BUSINESS NAME | Jackson Lewis P.C. |
| STATE OF HIGHEST COURT | NC |
| NAME OF HIGHEST STATE COURT | NC Supreme Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | No |
| SECONDARY ENTITY BUSINESS NAME | |
| WORKSITE ADDRESS1 | 18131 Slade School Road |
| WORKSITE ADDRESS2 | |
| WORKSITE CITY | Sandy Spring |
| WORKSITE COUNTY | MONTGOMERY |
| WORKSITE STATE | MD |
| WORKSITE POSTAL CODE | 20860 |
| WAGE RATE OF PAY FROM | $229,000.00 |
| WAGE RATE OF PAY FROM CLEANED | |
| WAGE RATE OF PAY TO | |
| WAGE UNIT OF PAY | Year |
| PREVAILING WAGE | $161,366.00 |
| 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 | Read |
| PREPARER FIRST NAME | Forrest |
| PREPARER MIDDLE INITIAL | |
| PREPARER BUSINESS NAME | Jackson Lewis P.C. |
| PREPARER EMAIL | Reza.Mohammady@jacksonlewis.com |
| BEGIN DATE CONVERTED | 2025-01-06 |
