| LCA CASE NUMBER | I-200-21320-708940 |
| STATUS | Certified |
| LCA CASE SUBMIT | 2021-11-16 |
| DECISION DATE | 2021-11-23 |
| VISA CLASS | H-1B |
| LCA CASE JOB TITLE | Internal Medicine Physician |
| SOC CODE | 29-1063.00 |
| SOC TITLE | Internists, General |
| FULL TIME POSITION | True |
| LCA CASE EMPLOYMENT START DATE | 2022-03-31 |
| END DATE | 2025-03-30 |
| TOTAL WORKER POSITIONS | 1 |
| NEW EMPLOYMENT | 0 |
| CONTINUED EMPLOYMENT | 0 |
| CHANGE PREVIOUS EMPLOYMENT | 0 |
| NEW CONCURRENT EMPLOYMENT | 0 |
| CHANGE EMPLOYER | 1 |
| AMENDED PETITION | 0 |
| LCA CASE EMPLOYER NAME | Baystate Medical Practices, Inc. |
| EMPLOYER ADDRESS1 | 759 Chestnut Street |
| EMPLOYER CITY | Springfield |
| EMPLOYER STATE | MA |
| EMPLOYER POSTAL CODE | 01199 |
| EMPLOYER COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER PHONE | 14137942571 |
| NAICS CODE | 62111 |
| EMPLOYER POC LAST NAME | Hartman |
| EMPLOYER POC FIRST NAME | Carolynn |
| EMPLOYER POC JOB TITLE | Provider Recruitment Coordinator |
| EMPLOYER POC ADDRESS1 | Office of Physician & Adv. Practitioner Recruitment |
| EMPLOYER POC ADDRESS2 | 280 Chestnut Street |
| EMPLOYER POC CITY | Springfield |
| EMPLOYER POC STATE | MA |
| EMPLOYER POC POSTAL CODE | 01199 |
| EMPLOYER POC COUNTRY | UNITED STATES OF AMERICA |
| EMPLOYER POC PHONE | 14137942325 |
| EMPLOYER POC EMAIL | carolynn.hartman@baystatehealth.org |
| AGENT REPRESENTING EMPLOYER | True |
| AGENT ATTORNEY LAST NAME | Berger |
| AGENT ATTORNEY FIRST NAME | Dan |
| AGENT ATTORNEY MIDDLE NAME | H |
| AGENT ATTORNEY ADDRESS1 | Curran, Berger & Kludt |
| AGENT ATTORNEY ADDRESS2 | 79 Masonic St |
| AGENT ATTORNEY CITY | Northampton |
| AGENT ATTORNEY STATE | MA |
| AGENT ATTORNEY POSTAL CODE | 01060 |
| AGENT ATTORNEY COUNTRY | UNITED STATES OF AMERICA |
| AGENT ATTORNEY PHONE | 14135843232 |
| AGENT ATTORNEY EMAIL ADDRESS | dhb@cbkimmigration.com |
| LAWFIRM NAME BUSINESS NAME | Curran, Berger & Kludt |
| STATE OF HIGHEST COURT | MA |
| NAME OF HIGHEST STATE COURT | Supreme Judicial Court |
| WORKSITE WORKERS | 1 |
| SECONDARY ENTITY | False |
| WORKSITE ADDRESS1 | Baystate Primary Care -Longmeadow |
| WORKSITE ADDRESS2 | 21 Dwight Road |
| LCA CASE WORKLOC1 CITY | Longmeadow |
| WORKSITE COUNTY | LONGMEADOW |
| LCA CASE WORKLOC1 STATE | MA |
| WORKSITE POSTAL CODE | 01108 |
| LCA CASE WAGE RATE FROM | 202500 |
| LCA CASE WAGE RATE TO | 327000 |
| LCA CASE WAGE RATE UNIT | Year |
| PREVAILING WAGE | 68869 |
| PW UNIT OF PAY | Year |
| PW WAGE LEVEL | I |
| PW OES YEAR | 7/1/2021 - 6/30/2022 |
| TOTAL WORKSITE LOCATIONS | 1 |
| AGREE TO LC STATEMENT | True |
| H1B DEPENDENT | False |
| WILLFUL VIOLATOR | False |
| PUBLIC DISCLOSURE | Disclose Business and Employment |
