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NORTH COUNTRY ADULT MEDICINE, PLLC

Company Details

Name: NORTH COUNTRY ADULT MEDICINE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 27 May 2003 (22 years ago)
Entity Number: 2911673
ZIP code: 13662
County: St. Lawrence
Place of Formation: New York
Address: 38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662

Contact Details

Phone +1 315-764-1121

DOS Process Agent

Name Role Address
NORTH COUNTRY ADULT MEDICINE, PLLC DOS Process Agent 38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662

U.S. Small Business Administration Profile

The U.S. Small Business Administration (SBA) helps Americans start, grow, and build resilient businesses.

Note: SBA was created in 1953 as an independent agency of the federal government to aid, counsel, assist and protect the interests of small business concerns; preserve free competitive enterprise; and maintain and strengthen the overall economy of our nation. SBA reviews Congressional and testifies on behalf of small businesses. It assesses the impact of regulatory burden on small businesses.

Phone Number:
E-mail Address:
Fax Number:
855-279-7911
Contact Person:
NEIL CICHETTI
User ID:
P0699092

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
EJHLN6ZLNZN5
CAGE Code:
46HJ4
UEI Expiration Date:
2026-01-30

Business Information

Activation Date:
2025-02-03
Initial Registration Date:
2005-10-17

Commercial and government entity program

The The Commercial And Government Entity Code (CAGE) is assigned by the Department of Defense's Defense Logistics Agency (DLA) and represents your company's physical address for GSA's mailings, payments, and administrative records.

Note: A CAGE Code enables a company to contract with the U.S. government, allowing bid on government contracts and to receive government payments. Also for business this means that it's a Verified business entity and Has a validated physical address.

CAGE number:
46HJ4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2024-03-09
CAGE Expiration:
2029-02-19
SAM Expiration:
2025-02-14

Contact Information

POC:
NEIL CICHETTI
Phone:
+1 315-764-1121
Fax:
+1 855-279-7911

National Provider Identifier

NPI Number:
1710052451

Authorized Person:

Name:
ELLEN M THOMSON
Role:
BILLING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3157641972

Form 5500 Series

Employer Identification Number (EIN):
542111742
Plan Year:
2023
Number Of Participants:
9
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:

History

Start date End date Type Value
2024-02-15 2025-05-01 Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, USA (Type of address: Service of Process)
2009-05-15 2024-02-15 Address 38 HOSPITAL DRIVE, MASSENA, NY, 13662, USA (Type of address: Service of Process)
2005-06-16 2009-05-15 Address FETTER & BURSTEIN, P.C., 507 PLUM ST, STE 300, SYRACUSE, NY, 13204, USA (Type of address: Service of Process)
2003-05-27 2005-06-16 Address FETTER & BURSTEIN, P.C., 90 PRESIDENTIAL PLAZA 5TH FLR., SYRACUSE, NY, 13202, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
250501025181 2025-05-01 BIENNIAL STATEMENT 2025-05-01
240215000236 2024-02-15 BIENNIAL STATEMENT 2024-02-15
210503060113 2021-05-03 BIENNIAL STATEMENT 2021-05-01
130524006193 2013-05-24 BIENNIAL STATEMENT 2013-05-01
110526002905 2011-05-26 BIENNIAL STATEMENT 2011-05-01

USAspending Awards / Contracts

Procurement Instrument Identifier:
6923G518A0026
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And All Options Value:
5000.00
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2017-10-01
Description:
OT::IGF::OT PROVIDE MEDICAL SERVICES TO REVIEW MEDICAL INFORMATION, INTERPRET MEDICAL TESTS, READ X-RAYS, PERFORM HANDS-ON MEDICAL EXAMS.
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q403: MEDICAL- EVALUATION/SCREENING
Procurement Instrument Identifier:
DTSL5517P1412
Award Or Idv Flag:
AWARD
Award Type:
BPA CALL
Action Obligation:
5888.00
Base And Exercised Options Value:
5888.00
Base And All Options Value:
5888.00
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2017-09-05
Description:
IGF::OT::IGF - 17 LEAD SCREENS, 39 XRAYS
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q403: MEDICAL- EVALUATION/SCREENING
Procurement Instrument Identifier:
DTSL5516A0012
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And All Options Value:
13000.00
Awarding Agency Name:
Department of Transportation
Performance Start Date:
2015-10-01
Description:
IGF::OT::IGF BPA CALL FOR CORPORATIONS MEDICAL PROFESSIONALS.
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE

USAspending Awards / Financial Assistance

Date:
2021-03-06
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
96219.00
Total Face Value Of Loan:
96219.00
Date:
2020-06-27
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
150000.00
Total Face Value Of Loan:
150000.00
Date:
2020-06-18
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
7000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
49989.15
Total Face Value Of Loan:
49989.15

Paycheck Protection Program

Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
49989.15
Current Approval Amount:
49989.15
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
50423.3
Date Approved:
2021-03-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
96219
Current Approval Amount:
96219
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
97197.01

Date of last update: 30 Mar 2025

Sources: New York Secretary of State