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  5. NORTH COUNTRY ADULT MEDICINE, PLLC

NORTH COUNTRY ADULT MEDICINE, PLLC

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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

Phone Number:
315-764-1121
E-mail Address:
ncichetti@yahoo.com
Fax Number:
855-279-7911
Contact Person:
NEIL CICHETTI
User ID:
P0699092

Unique Entity ID

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

CAGE number:
46HJ4
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-02-03
CAGE Expiration:
2030-02-03
SAM Expiration:
2026-01-30

Contact Information

POC:
NEIL CICHETTI

National Provider Identifier

NPI Number:
1710052451
Link:
View on NPI website

Authorized Person:

Name:
ELLEN M THOMSON
Role:
BILLING SPECIALIST
Phone:
3157641121

Taxonomy:

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

Contacts:

Phone:
+1 315-764-1121
Fax:
3157641972

Form 5500 Series

Employer Identification Number (EIN):
542111742
Plan Year:
2023
Number Of Participants:
9
Sponsors Telephone Number:
3157641121
File:
View File
Plan Year:
2022
Number Of Participants:
9
Sponsors Telephone Number:
3157641121
File:
View File

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
Link:
View Award on USAspending website
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
Link:
View Award on USAspending website
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
Link:
View Award on USAspending website
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
Link:
View on USAspending
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
Link:
View on USAspending
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
Link:
View on USAspending
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
Link:
View on USAspending
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

Jobs Reported:
12
Initial Approval Amount:
$96,219
Date Approved:
2021-03-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$96,219
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$97,197.01
Servicing Lender:
Community Bank, National Association
Use of Proceeds:
Payroll: $96,214
Utilities: $1
Jobs Reported:
5
Initial Approval Amount:
$49,989.15
Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$49,989.15
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$50,423.3
Servicing Lender:
Community Bank, National Association
Use of Proceeds:
Payroll: $49,989.15

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38 HOSPITAL DRIVE, MASSENA, NY, United States, 13662

JUST PROPERTIES, LLC NORTH COUNTRY IPA, INC. NORTH COUNTRY MEDICAL MANAGEMENT LLC

Date of last update: 30 Mar 2025

Sources: New York Secretary of State

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