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BOISE RADIOLOGY GROUP, PLLC

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Company Details

Name: BOISE RADIOLOGY GROUP, PLLC
Jurisdiction: Idaho
Legal type: Limited Liability Company (D)
Status: Active-Existing
Date of registration: 29 Dec 2004 (21 years ago)
Financial Date End: 31 Dec 2025
Entity Number: 119171
Place of Formation: IDAHO
File Number: 119171
ZIP code: 83702
County: Ada County
Principal Address: 115 W MAIN ST #202 BOISE, ID 83702
Mailing Address: AUDRA FREZZA 620 W HAYS ST BOISE, ID 83702-5511

Agent

Name Role Address
Audra Frezza Agent 620 W HAYS ST, BOISE, ID 83702

Manager

Name Role Address Appointed On Resigned On
Sean Carr Manager 620 W HAYS ST, BOISE, ID 83702 2021-11-03 2023-11-03
Sean Carr MD Manager 620 W HAYS ST, BOISE, ID 83702 2020-11-17 No data
Russell Wright MD Manager 620 W HAYS ST, BOISE, ID 83702 2023-11-03 No data

Links between entities

Type:
Headquarter of
Company Number:
3220049
State:
CONNECTICUT
Type:
Headquarter of
Company Number:
undefined605097555
State:
WASHINGTON

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.

CAGE Code:
74UD0
UEI Expiration Date:
2017-07-05

Business Information

Doing Business As:
BOISE RADIOLOGY GROUP
Activation Date:
2016-07-05
Initial Registration Date:
2014-05-06

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:
74UD0
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-01-22
CAGE Expiration:
2030-01-22
SAM Expiration:
2026-01-20

Contact Information

POC:
AUDRA FREZZA

National Provider Identifier

NPI Number:
1740216175
Certification Date:
2024-03-04

Authorized Person:

Name:
MS. LISA SMITH
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
2085N0700X - Neuroradiology Physician
Is Primary:
No
Selected Taxonomy:
2085R0204X - Vascular & Interventional Radiology Physician
Is Primary:
No
Selected Taxonomy:
2085R0202X - Diagnostic Radiology Physician
Is Primary:
Yes

Contacts:

Fax:
2083811791

Form 5500 Series

Employer Identification Number (EIN):
820301061
Plan Year:
2023
Number Of Participants:
47
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
52
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
45
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
41
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
38
Sponsors Telephone Number:

Filing

Filing Name Filing Number Filing date
Annual Report 0006002666 2024-12-03
Annual Report 0005455597 2023-11-03
Annual Report 0004968742 2022-11-03
Annual Report 0004476152 2021-11-03
Annual Report 0004069539 2020-11-17

USAspending Awards / Contracts

Procurement Instrument Identifier:
AG02RBP130060
Award Or Idv Flag:
AWARD
Award Type:
PO
Action Obligation:
-3000.00
Base And Exercised Options Value:
-3000.00
Base And All Options Value:
-3000.00
Awarding Agency Name:
Department of Agriculture
Performance Start Date:
2013-07-16
Description:
IGF::CT::IGF
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q522: MEDICAL- RADIOLOGY

USAspending Awards / Financial Assistance

Date:
2020-04-07
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:
1034200.00
Total Face Value Of Loan:
1034200.00

Paycheck Protection Program

Date Approved:
2020-04-05
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
1034200
Current Approval Amount:
1034200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
1044683.67

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Date of last update: 24 Jun 2025

Sources: Idaho Secretary of State