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NYU LANGONE IPA INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
NYU LANGONE IPA INC (EIN 36-4841069)
Tax period
2018-09-01 to 2019-08-31
Filed
2020-07-07
IRS object ID
202001899349300615
Schema version
2018v3.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2020-07-07T08:15:09-05:00ReturnTs
Tax Period End2019-08-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-09-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN364841069EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NYU LANGONE IPA INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNYULBusinessNameControlTxt
Phone2122633092PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1550 FIRST AVENUE HCC15AddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDANIEL J WIDAWSKYPersonNm
Person TitleTREASURERPersonTitleTxt
Phone2122633092PhoneNum
Signature2020-07-07SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address216.165.126.117IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-07-07IPDt
IP Tm08:53:45IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEE3F2146BB06A45D51569A3DEFB8C9CF1D9F1973AtSubmissionCreationDeviceId
At Submission Filing Device IdEE3F2146BB06A45D51569A3DEFB8C9CF1D9F1973AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-11-06 18:47:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDANIEL J WIDAWSKYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1550 FIRST AVENUE HCC15AddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,881,985GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION WILL CONTRACT WITH PHYSICIANS AND OTHER PROVIDERS WHO SERVE THE MEDICAID POPULATION IN ORDER TO FACILITATE THE DELIVERY OF HIGH QUALITY MEDICAL CARE TO THOSE INDIVIDUALS.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent1VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$1,140,093PYProgramServiceRevenueAmt
CY Program Service Revenue$1,881,985CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,140,093PYTotalRevenueAmt
CY Total Revenue$1,881,985CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$482,736PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$977,849CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,367PYOtherExpensesAmt
CY Other Expenses$12,768CYOtherExpensesAmt
PY Total Expenses$494,103PYTotalExpensesAmt
CY Total Expenses$990,617CYTotalExpensesAmt
PY Revenues Less Expenses$645,990PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$891,368CYRevenuesLessExpensesAmt
Total Assets BOY$1,981,986TotalAssetsBOYAmt
Total Assets EOY$2,479,253TotalAssetsEOYAmt
Total Liabilities BOY$1,335,996TotalLiabilitiesBOYAmt
Total Liabilities EOY$941,893TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$645,990NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,537,360NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE BOARD ADOPTED MISISON STATEMENT IS: TO OPERATE A MEDICAID-FOCUSED INDEPENDENT PRACTICE ASSOCIATION ("IPA") FOR THE BENEFIT OF THE INDIGENT MEDICAID POPULATION BY CONTRACTING WITH MANAGED CARE ORGANIZATIONS ("MCOS") THAT SERVE SUCH MEDICAID POPULATIONS, THEREBY MAKING AVAILABLE TO SUCH POPULATION A CADRE OF MEDICAID-ACCEPTING PHYSICIANS, ACROSS MULTIPLE SPECIALTIES, AND TO ENHANCE THE DELIVERY OF HIGH QUALITY CARE TO MEDICAID PATIENTS THROUGH THE DEVELOPMENT OF PROGRAMS AND PROCEDURES TO ENCOURAGE PATIENT SAFETY AND QUALITY IMPROVEMENT INITIATIVES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$970,804ExpenseAmt
Revenue$1,881,985RevenueAmt
DescOPERATE A MEDICAID-FOCUSED IPA FOR THE BENEFIT OF THE INDIGENT MEDICAID POPULATION BY CONTRACTING WITH MCOS THAT SERVE SUCH MEDICAID POPULATIONS, THEREBY MAKING AVAILABLE TO SUCH POPULATION A CADRE OF MEDICAID-ACCEPTING PHYSICIANS, ACROSS MULTIPLE SPECIALTIES, AND TO ENHANCE THE DELIVERY OF HIGH QUALITY CARE TO MEDICAID PATIENTS THROUGH THE DEVELOPMENT OF PROGRAMS AND PROCEDURES TO ENCOURAGE PATIENT SAFETY AND QUALITY IMPROVEMENT INITIATIVES.Desc
Total Program Service Expenses$970,804TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member1IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy0ConflictOfInterestPolicyInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DANIEL J WIDAWSKY TREASURERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2122633092PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1550 FIRST AVENUEAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
ANDREW W BROTMAN MD
PRESIDENT1.0060.00Yes (X)Yes (X)$0$1,596,018$946,496
RICHARD J DONOGHUE
VICE PRESIDENT (THROUGH 2/2019)1.0060.00Yes (X)Yes (X)$0$703,013$38,602
LARRY MCREYNOLDS
DIRECTOR1.00Yes (X)$0$0$0
ANNETTE JOHNSON
SECRETARY1.0060.00Yes (X)$0$789,644$268,765
DANIEL J WIDAWSKY
TREASURER1.0060.00Yes (X)$0$917,518$105,657
KARIM HABIBI FROM 32019
VICE PRESIDENT1.0060.00Yes (X)Yes (X)$0$1,014,109$36,305
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$5,020,302TotReportableCompRltdOrgAmt
Total Other Compensation$1,395,825TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescCARE COORDINATIONDesc
Business900099BusinessCd
Total Revenue Column$1,881,985TotalRevenueColumnAmt
Related Or Exempt Func Income$1,881,985RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,881,985TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,881,985TotalRevenueColumnAmt
Related Or Exempt Func Income$1,881,985RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$744,744TotalAmt
Program Services$729,849ProgramServicesAmt
Management And General$14,895ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$233,105TotalAmt
Program Services$228,443ProgramServicesAmt
Management And General$4,662ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$728TotalAmt
Program Services$713ProgramServicesAmt
Management And General$15ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescPURCHASED SERVICESDesc
Total$12,040TotalAmt
Program Services$11,799ProgramServicesAmt
Management And General$241ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$990,617TotalAmt
Program Services$970,804ProgramServicesAmt
Management And General$19,813ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,981,986BOYAmt
EOY$1,981,986EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$497,267EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,981,986BOYAmt
EOY$2,479,253EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$941,893BOYAmt
EOY$941,893EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$394,103BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,335,996BOYAmt
EOY$941,893EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$645,990BOYAmt
EOY$1,537,360EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$645,990BOYAmt
EOY$1,537,360EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,981,986BOYAmt
EOY$2,479,253EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$891,368ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NYU LANGONE HOSPITALSBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN133971298EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDUE FROM RELATED ORGANIZATIONSDesc
Book Value$497,267BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$497,267TotalBookValueOtherAssetsAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ANDREW W BROTMAN MD
PRESIDENT$0$1,587,417$0$0$0$8,601$0$946,496$0$0$0$2,542,514$0$0
RICHARD J DONOGHUE
VICE PRESIDENT (THROUGH 2/2019)$0$680,007$0$0$0$23,006$0$27,500$0$11,102$0$741,615$0$0
ANNETTE JOHNSON
SECRETARY$0$789,644$0$0$0$0$0$263,148$0$5,617$0$1,058,409$0$0
DANIEL J WIDAWSKY
TREASURER$0$917,518$0$0$0$0$0$101,257$0$4,400$0$1,023,175$0$0
KARIM HABIBI FROM 32019
VICE PRESIDENT$0$924,070$0$0$0$90,039$0$27,500$0$8,805$0$1,050,414$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 4BFormAndLineReferenceDesc
ExplanationTHE FOLLOWING OFFICERS PARTICIPATED IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN ("SERP") DURING CALENDAR YEAR 2018. THE AMOUNTS LISTED BELOW REPRESENT THE EMPLOYER CONTRIBUTIONS TO THIS PLAN FOR CALENDAR YEAR 2018. THESE AMOUNTS ARE REPORTED AS SHARED COSTS BETWEEN NYULH AND NYU GROSSMAN SCHOOL OF MEDICINE. ANDREW W. BROTMAN, MD - $918,996; ANNETTE JOHNSON, JD - $235,648; DANIEL J. WIDAWSKY - $101,257. THE SUPPLEMENTAL SERP CONTRIBUTIONS WERE MADE PURSUANT TO NEGOTIATED AGREEMENTS WITH THE OFFICERS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE SOLE MEMBER OF THE CORPORATION IS NYU LANGONE HEALTH SYSTEM, INC.
FORM 990, PART VI, SECTION A, LINE 7AWITH RESPECT TO THE ELECTION OF THE BOARD OF TRUSTEES OF NYU LANGONE IPA, NYU LANGONE HEALTH SYSTEM, AS THE SOLE MEMBER HAS THE POWER AND AUTHORITY TO: (A) ELECT THE CORPORATION'S BOARD; (B) REMOVAL OF THE CORPORATION'S BOARD; AND (C) FILLING ANY VACANCIES IN THE CORPORATION'S BOARD.
FORM 990, PART VI, SECTION A, LINE 7BTHE FOLLOWING POWERS AND AUTHORITY ARE RESERVED EXCLUSIVELY TO THE MEMBER: (A) ELECTION OF THE CORPORATION'S BOARD; (B) REMOVAL OF THE CORPORATION'S BOARD; (C) FILLING ANY VACANCIES IN THE CORPORATION'S BOARD; (D) AMENDING OR REPEALING THESE BY-LAWS OR ADOPTING NEW BY-LAWS; (E) APPROVING THE CORPORATION'S MERGER OR CONSOLIDATION WITH ANOTHER ENTITY; (F) APPROVING THE SALE, LEASE, EXCHANGE OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF THE ASSETS OF THE CORPORATION; (G) REVIEWING THE VISION, MISSION AND STRATEGIC AND FINANCIAL PLANS OF THE CORPORATION; (H) REVIEWING THE CORPORATION'S ANNUAL OPERATING AND CAPITAL BUDGETS, PROVIDED THAT FINAL APPROVAL OF THE BUDGETS SHALL REMAIN WITH THE CORPORATION; (I) APPROVING ANY TRANSACTION HAVING A VALUE OF $5,000,000 OR MORE; AND (J) APPROVING THE CREATION, ACQUISITION AND/OR DISSOLUTION OF AN ENTITY IN WHICH THE CORPORATION IS PROPOSED TO BE, OR IS, THE CONTROLLING MEMBER.
FORM 990, PART VI, SECTION B, LINE 11BDESCRIPTION OF THE PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW THE FORM 990: 1. NYU LANGONE HEALTH'S ("NYULH") FINANCE DEPARTMENT DRAFTS THE FORM 990 AND THE ACCOMPANYING SCHEDULE BASED ON THE FISCAL YEAR'S FINANCIAL ACTIVITY. 2. THE DRAFT IS REVIEWED BY THE VICE PRESIDENT OF FINANCE AND CHIEF FINANCIAL OFFICER FOR COMPLETENESS AND ACCURACY. 3. THE REVIEWED DRAFT IS PRESENTED TO THE NYULH BOARD OF TRUSTEES' AUDIT COMMITTEE AS WELL AS CERTAIN OTHER OFFICERS FOR REVIEW. 4. ONCE APPROVED BY THE AUDIT COMMITTEE, THE FORM 990 IS MADE AVAILABLE TO THE FULL BOARD AND THEN IT IS FORWARDED TO THE IRS.
FORM 990, PART VI, LINES 12A-BNYU LANGONE IPA HAS FORMALLY ADOPTED THE CONFLICT OF INTEREST POLICY OF ITS SOLE MEMBER, NYULH. THIS POLICY IS MONITORED ON AN ANNUAL BASIS AND REQUIRES OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES TO DISCLOSE ANY CONFLICTS OF INTEREST. THESE DISCLOSURES ARE REVIEWED BY NYULH ANNUALLY.
FORM 990, PART VI, LINES 13-14NYU LANGONE IPA HAS FORMALLY ADOPTED THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF ITS SOLE MEMBER, NYULH.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE NYU LANGONE HEALTH SYSTEM OFFICE OF GENERAL COUNSEL MAINTAINS COPIES OF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES. A COPY OF THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES MAY BE OBTAININED BY CONTACTING: NYU LANGONE HEALTH SYSTEM OFFICE OF THE GENERAL COUNSEL 550 FIRST AVENUE NEW YORK, NEW YORK 10016 TELEPHONE NUMBER: (212) 263-7300

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (31 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtControlled OrganizationControlledOrganizationIndBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtAddress Line1ForeignAddress/AddressLine1TxtProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdLegal Domicile Foreign CountryLegalDomicileForeignCountryCd
NEW YORK UNIVERSITY
726 BROADWAYNEW YORKNY10003135562308UNIVERSITYNY501(C)(3)LINE 20
NYU LANGONE HEALTH SYSTEM
550 FIRST AVENUE MSB 153NEW YORKNY10016472613531SUPPORTING. ORG.NY501(C)(3)LINE 12B, IIYes (1)NEW YORK UNIVERSITY
34TH STREET CANCER CENTER INC
C/O NYUHC 550 FIRST AVENUENEW YORKNY10016300622470CANCER CARENY501(C)(3)LINE 12C, III-FIYes (1)NYU LANGONE HEALTH SYSTEM
HAROLD ACTON TRUST
726 BROADWAY 9TH FLNEW YORKNY10003137050560SUPPORT OF NYU'S CAMPUS IN FLORENCE, ITALYNY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
HORTENSE ACTON TRUST
70 WASHINGTON SQ SNEW YORKNY10013367110976SUPPORT OF NYU'S CAMPUS IN FLORENCE, ITALYNY501(C)(3)PFYes (1)NEW YORK UNIVERSITY
KJC (REY JUAN CARLOS I DE ESPANA DE LA UNIVERSIDAD DE NUEVA YORK)
SUPPORT NYU'S PROGRAM IN SPAINYes (1)NEW YORK UNIVERSITYCALLE SEGRE 8MADRIDSP28002SP
NATIONAL CENTER ON PHILANTHROPY AND THE LAW
110 WEST 3RD ST 2ND FLNEW YORKNY10012133954405STUDY,RESEARCH, EDUCATION ON PHILANTHROPY & THE LAWNY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
NEW YORK UNIVERSITY IN ABU DHABI CORP
70 WASHINGTON SQ SNEW YORKNY10013262652713SUPPORT NYU COLLEGE IN ABU DHABINY501(C)(3)LINE 2Yes (1)NEW YORK UNIVERSITY
NYU IMAGING INC
545 FIRST AVENUENEW YORKNY10016134000622SUPPORT NYU SCHOOL OF MEDICINENY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
NYU SCHOOL OF LAW FOUNDATION
161 AVE OF THE AMERICAS 504NEW YORKNY10013136161036SUPPORT NYU'S SCHOOL OF LAWNY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
NYU SCHOOL OF LAW HOUSING ASSISTANCE CO (THOUGH 81419)
161 AVE OF THE AMERICAS 504NEW YORKNY10013134043221SUPPORT NYU'S SCHOOL OF LAWNY501(C)(3)LINE 12A, IYes (1)NYU'S SCHOOL OF LAW FOUNDATION
NYU SCHOOL OF LAW RECRUITMENT ASSIST CO (THOUGH 81419)
161 AVE OF THE AMERICAS 504NEW YORKNY10013134043182SUPPORT NYU'S SCHOOL OF LAWNY501(C)(3)LINE 12A, IYes (1)NYU'S SCHOOL OF LAW FOUNDATION
NYU SCHOOL OF LAW FACULTY RETENTION ASSIST CORP (THOUGH 81419)
161 AVE OF THE AMERICAS 504NEW YORKNY10013134047911SUPPORT NYU'S SCHOOL OF LAWNY501(C)(3)LINE 12A, IYes (1)NYU'S SCHOOL OF LAW FOUNDATION
WASHINGTON SQUARE LEGAL SERVICES INC
161 AVE OF THE AMERICAS 504NEW YORKNY10013237392120CERTAIN PUBLIC INTEREST ACTIVITIES OF NYU'S SCHOOL OF LAWNY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
LUTHERAN AUGUSTANA CECR INC
5434 2ND AVENUEBROOKLYNNY11220112150953EXTENDED CARENY501(C)(3)LINE 10Yes (1)NYU LANGONE HEALTH SYSTEM
OHP PHSP INC (THOUGH 32719)
5800 3RD AVENUEBROOKLYNNY11220113245559INSURANCENY501(C)(4)Yes (1)NYU LANGONE HOSPITALS
SHORE HILL HOUSING COMPANY INC (THROUGH 11818)
9000 SHORE ROADBROOKLYNNY11220237405105HOUSINGNY501(C)(3)LINE 10Yes (1)NYU LANGONE HEALTH SYSTEM
HARBOR HILL HOUSING (THOUGH 112619)
150 55TH STREETBROOKLYNNY11220113152691HOUSINGNY501(C)(3)LINE 10Yes (1)NYU LANGONE HEALTH SYSTEM
SUNSET BAY COMMUNITY SERVICES (THOUGH 9119)
150 55TH STREETBROOKLYNNY11220112439925DAY CARE & SENIOR SERVICESNY501(C)(3)LINE 7Yes (1)NYU LANGONE HEALTH SYSTEM
SUNSET GARDENS HOUSING DEVELOPMENT FUND CORP (THOUGH 121119)
150 55TH STREETBROOKLYNNY11220203461755HOUSINGNY501(C)(3)LINE 10Yes (1)NYU LANGONE HEALTH SYSTEM
NYU IN LONDON
981074101SUPPORT NYU'S PROGRAM IN LONDONYes (1)NEW YORK UNIVERSITY6 BEDFORD SQUARELONDONUKWC1B 3RAUK
NYU IN TEL-AVIV LTD
981058326SUPPORT NYU'S PROGRAM IN TEL-AVIVYes (1)NEW YORK UNIVERSITYTUVAL 13TEL AVIVIS52522IS
NEW YORK UNIVERSITY IN FRANCE
981058568SUPPORT NYU'S PROGRAM IN FRANCEYes (1)NEW YORK UNIVERSITY56 RUE DE PASSYPARISFR75016FR
NEW YORK UNIVERSITY IN AFGHANISTAN
SUPPORT NYU'S ACTIVITIES IN AFGHANISTANYes (1)NEW YORK UNIVERSITY150 MASJID E HAJI ABDURRAHIM ST CHAKABULAFAF
NYU LANGONE HOSPITALS
550 FIRST AVENUENEW YORKNY10016133971298HOSPITALNY501(C)(3)LINE 3Yes (1)NYU LANGONE HEALTH SYSTEM
NYU LANGONE MSO INC
550 FIRST AVENUENEW YORKNY10016824528600CONTRACT FOR DELIVERY/PROVISION OF HEALTH SERVICESNY501(C)(3)LINE 12A, IYes (1)NEW YORK UNIVERSITY
NYU WINTHROP HOSPITAL (THOUGH 73119)
259 FIRST STREETMINEOLANY11501111633486HOSPITALNY501(C)(3)LINE 3Yes (1)NYU LANGONE HEALTH SYSTEM
WINTHROP UNIV HOSPITAL SVCS CORP
700 HICKSVILLE ROADBETHPAGENY11714112496631TITLE HOLDINGNY501(C)(2)Yes (1)NYU WINTHROP HOSPITAL
WINTHROP FACULTY MEDICAL AFFILIATES UFPC
222 STATION PLAZA NORTHMINEOLANY11501452439597HEALTHCARENY501(C)(3)LINE 12A, IYes (1)NYU WINTHROP HOSPITAL
WINTHROP MEDICAL AFFILIATES URGENT CARE UFPC
222 STATION PLAZA NORTHMINEOLANY11501465482775HEALTHCARENY501(C)(3)LINE 12A, IYes (1)NYU WINTHROP HOSPITAL
WINTHROP COMMUNITY MEDICAL AFFILIATES PC
222 STATION PLAZA NORTH SUITE 350MINEOLANY11501472665045HEALTHCARENY501(C)(3)LINE 12A, IYes (1)NYU WINTHROP HOSPITAL

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NYU LANGONE DIAGNOSTICS LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1550 FIRST AVENUEAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10016ZIPCd
FieldValueIRS element (for citing)
EIN301001205EIN
Primary ActivitiesOUTREACH TESTINGPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile Foreign CountryLegalDomicileForeignCountryCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationIndAddress Line1ForeignAddress/AddressLine1TxtProvince Or StateForeignAddress/ProvinceOrStateNmCountryForeignAddress/CountryCdForeign PostalForeignAddress/ForeignPostalCdCityForeignAddress/CityNmEINEINLegal Domicile StateLegalDomicileStateCd
CCC 550 INSURANCE SCC
550 FIRST AVENUENEW YORKNY10016PROF LIAB COVERAGEBBN/ACYes (1)
LA PIETRA SRL
HOLDS PROPERTY COMPRISING NYU'S FLORENCE CAMPUSITN/ACYes (1)VIA BOLOGNESE 120FLORENCEIT50139
NIU DA ED INFOR CONSULTING CO LTD
SUPPORT NYU'S PROGRAM IN CHINACHN/ACYes (1)1555 CENTURY AVENUE ROOM 1063SHANGHAICH200062PUDONG NEW AREA
SHORE HILL HOUSING ASSOCIATES GP INC
150 55TH STREETBROOKLYNNY11220HOUSINGN/ACYes (1)262243695NY
WINTHROP CLINICAL PARTNERS INC
259 FIRST STREETMINEOLANY11501HEALTHCAREN/AC0454088169NY
CARDIOVASCULAR MEDICAL ASSOCIATES PC
975 STEWART AVENUEGARDEN CITYNY11530HEALTHCAREN/AC0273629386NY
WINTHROP IPA
700 HICKSVILLE ROADBETHPAGENY11714MANAGEMENT SERVICESN/AC0454951888NY
LONG ISLAND PRIMARY CARE ASSOCIATES
700 HICKSVILLE ROADBETHPAGENY11714HEALTHCAREN/AC0113307827NY
WINTHROP CHILD NEUROLOGY ASSOCIATES PC
173 MINEOLA BOULEVARD SUITE 101MINEOLANY11501HEALTHCAREN/AC0205682886NY
WINTHROP DENTAL PC
700 HICKSVILLE ROADBETHPAGENY11714HEALTHCAREN/AC0454055800NY
WINTHROP PEDIATRIC ASSOCIATES PC
222 STATION PLAZAMINEOLANY11501HEALTHCAREN/AC0112891904NY
WOMEN'S CONTEMPORARY CARE ASSOCIATES PC
120 MINEOLA BOULEVARD SUITE 100MINEOLANY11501HEALTHCAREN/AC0112707087NY
WINTHROP RADIOLOGY SERVICES PC
121 MINEOLA BOULEVARDMINEOLANY11501HEALTHCAREN/AC0113016374NY
MEDICAL GROUP OF MINEOLA PC
222 STATION PLAZAMINEOLANY11501HEALTHCAREN/AC0811000704NY
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd