UNIVERSITY PHYSICIANS OF BROOKLYN INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY PHYSICIANS OF BROOKLYN INC (EIN 11-3190652)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-15
- IRS object ID
- 201943199349321559
- Schema version
- 2018v3.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-15T18:09:33-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271728945 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PKF O'CONNOR DAVIES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 665 FIFTH AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10022 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 113190652 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY PHYSICIANS OF BROOKLYN INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 7182708357 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 CLARKSON AVENUE MSC 1285 | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11203 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALAN DZIJA | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 7182708357 | PhoneNum |
| Signature | 2019-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GARRETT M HIGGINS | PreparerPersonNm |
| PTIN | P00543209 | PTIN |
| Phone | 2122862600 | PhoneNum |
| Preparation | 2019-11-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.15.211.182 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-15 | IPDt |
| IP Tm | 16:33:03 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B29914CEB47F2C50F9800CDE5B5AE22990D509AB | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM URBAN MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 CLARKSON AVENUE MSC 1285 | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $66,808,969 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.DOWNSTATE.EDU/PHYSICIANS | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL CARE TO ITS PATIENTS AND SUPPORT THE EDUCATIONAL OBJECTIVES OF SUNY HEALTH SCIENCE CENTER AT BROOKLYN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 547 | TotalEmployeeCnt |
| Total Volunteers | 6 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $35,152 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $69,234,939 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $66,804,919 | CYProgramServiceRevenueAmt |
| PY Investment Income | $58,920 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,050 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $69,293,859 | PYTotalRevenueAmt |
| CY Total Revenue | $66,808,969 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $42,060,200 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $42,858,808 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $24,811,161 | PYOtherExpensesAmt |
| CY Other Expenses | $26,936,259 | CYOtherExpensesAmt |
| PY Total Expenses | $66,871,361 | PYTotalExpensesAmt |
| CY Total Expenses | $69,795,067 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,422,498 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,986,098 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $36,818,044 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,550,456 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,122,849 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,841,359 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,695,195 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,709,097 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION'S PRIMARY MISSION IS TO PROVIDE MEDICAL CARE TO ITS PATIENTS AND SUPPORT THE EDUCATIONAL OBJECTIVES OF STATE UNIVERSITY OF NEW YORK HEALTH SCIENCE CENTER AT BROOKLYN BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS, INTERNS, RESIDENTS AND FELLOWS OF THE UNIVERSITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $65,831,659 | ExpenseAmt |
| Revenue | $66,804,919 | RevenueAmt |
| Desc | UNIVERSITY PHYSICIANS OF BROOKLYN("UPB") PROVIDES MEDICAL CARE TO ITS PATIENTS AS WELL AS FURTHERS THE EDUCATIONAL OBJECTIVES OF THE STATE UNIVERSITY OF NEW YORK THROUGH CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS, INTERNS, RESIDENTS, AND FELLOWS OF THE UNIVERSITY. THE CORPORATION IS FOR THE EXCLUSIVE PURPOSE OF SUPPORTING THE EDUCATIONAL OBJECTIVES OF DOWNSTATE UNIVERSITY MEDICAL CENTER BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION TO APPROXIMATELY 1,700 STUDENTS AND 920 RESIDENTS AND FELLOWS OF THE UNIVERSITY IN 55 MEDICAL SPECIALTIES AND TO ENGAGE IN THE PROFESSION OF MEDICINE. SPECIFICALLY, THE CLINICAL PRACTICE MANAGEMENT PLAN (CPMP) IS A MULTI-SPECIALTY ACADEMIC FACULTY PRACTICE PLAN COMPRISED OF 18 DEPARTMENTS WITH APPROXIMATELY 300 PHYSICIANS. UPB IS RESPONSIBLE FOR PROVIDING PAYROLL, ACCOUNTING, BILLING, MANAGED CARE CONTRACTING, PURCHASING AND STAFFING SERVICES TO THESE DEPARTMENTS IN SUPPORT OF THE STATE UNIVERSITY OF NEW YORK AND ITS DOWNSTATE UNIVERSITY MEDICAL CENTER. | Desc |
| Total Program Service Expenses | $65,831,659 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 547 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALAN DZIJA CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7182708357 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 450 CLARKSON AVE MSC 1285 | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11203 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (32 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| WILLIAM URBAN MD | |||||||||
| PRESIDENT AND PHYSICIAN | 7.50 | 30.00 | Yes (X) | Yes (X) | $97,290 | $438,603 | $23,321 | ||
| DEBORAH REEDE MD | |||||||||
| VICE-PRESIDENT AND PHYSICIAN | 9.00 | 28.50 | Yes (X) | Yes (X) | $199,931 | $582,359 | $9,315 | ||
| RICHARD ROSENFELD MD | |||||||||
| SECRETARY/TREASURER AND PHYSICIAN | 7.50 | 30.00 | Yes (X) | Yes (X) | $118,955 | $504,258 | $0 | ||
| DAVID SCHWARTZ MD | |||||||||
| DIRECTOR AND PHYSICIAN | 34.50 | 3.00 | Yes (X) | $501,290 | $111,786 | $41,321 | |||
| JOHN DANIAS MD | |||||||||
| DIRECTOR AND PHYSICIAN | 10.00 | 27.50 | Yes (X) | $121,250 | $353,332 | $23,321 | |||
| MORO SALIFU MD | |||||||||
| DIRECTOR AND ASSOCIATE PROFESSOR | 10.00 | 27.50 | Yes (X) | $229,355 | $589,126 | $23,321 | |||
| MICHAEL LUCCHESI MD | |||||||||
| DIRECTOR AND PHYSICIAN | 10.50 | 27.00 | Yes (X) | $190,000 | $526,319 | $42,221 | |||
| ALEXANDER SCHWARTZMAN MD | |||||||||
| PROFESSOR AND DIRECTOR | 13.00 | 24.50 | Yes (X) | $188,255 | $344,654 | $27,171 | |||
| ALLA AKIVIS MD | |||||||||
| DIRECTOR | 15.00 | 22.50 | Yes (X) | $150,735 | $215,337 | $36,490 | |||
| AYMAN FANOUS MD | |||||||||
| DIRECTOR | 1.00 | 36.50 | Yes (X) | $0 | $309,265 | $23,321 | |||
| STANLEY FISHER MD | |||||||||
| DIRECTOR AND PAST PRESIDEN | 1.00 | 36.50 | Yes (X) | $0 | $430,192 | $23,321 | |||
| JENNY LIBIEM MD | |||||||||
| DIRECTOR | 5.00 | 32.50 | Yes (X) | $37,008 | $410,429 | $28,321 | |||
| DANIEL ROSENBAUM MD | |||||||||
| DIRECTOR | 5.00 | 32.50 | Yes (X) | $66,498 | $386,233 | $23,321 | |||
| STEPHEN WADOWSKI MD | |||||||||
| DIRECTOR | 1.00 | 36.50 | Yes (X) | $0 | $357,232 | $23,321 | |||
| JEFFREY WEISS MD | |||||||||
| DIRECTOR | 1.50 | 36.00 | Yes (X) | $0 | $65,033 | $0 | |||
| AUDREE BENDO MD | |||||||||
| DIRECTOR | 20.00 | 15.50 | Yes (X) | $263,320 | $206,087 | $47,621 | |||
| RAINER GRUESSNER MD | |||||||||
| DIRECTOR | 15.00 | 22.50 | Yes (X) | $366,732 | $495,166 | $9,315 | |||
| CARLOS PATO MD | |||||||||
| DIRECTOR | 1.00 | 36.50 | Yes (X) | $0 | $703,863 | $9,315 | |||
| EDWARD HEILMAN MD | |||||||||
| DIRECTOR | 1.00 | 36.50 | Yes (X) | $0 | $112,943 | $23,321 | |||
| SIMON RABINOWITZ MD | |||||||||
| DIRECTOR | 5.00 | 32.50 | Yes (X) | $37,554 | $246,463 | $24,437 | |||
| ERIC SHRIER MD | |||||||||
| DIRECTOR AND PHYSICIAN | 25.00 | 12.50 | Yes (X) | $288,379 | $156,913 | $23,321 | |||
| LORI DONNELL | |||||||||
| EXECUTIVE DIRECTOR | 20.00 | 17.75 | Yes (X) | $137,241 | $125,856 | $2,843 | |||
| ALAN DZIJA | |||||||||
| CFO | 37.50 | Yes (X) | $253,531 | $0 | $0 | ||||
| LAUREN GABELMAN | |||||||||
| INTERIM COO | 10.00 | 27.50 | Yes (X) | $50,137 | $149,456 | $1,371 | |||
| JOSEPH TESTANI | |||||||||
| ADMINISTATOR | 14.00 | 23.50 | $107,616 | $172,632 | $11,872 | Yes (X) | |||
| MARSHALL LIEBERMAN | |||||||||
| ADMINISTATOR | 37.50 | $229,563 | $0 | $30,670 | Yes (X) | ||||
| ROSS CLINCHY | |||||||||
| EXECUTIVE DIRECTOR (THRU MAR. 2018) | 7.50 | 30.00 | $0 | $288,414 | $23,321 | Yes (X) | |||
| ROMAN SHINDER MD | |||||||||
| PHYSICIAN | 37.50 | $437,283 | $0 | $0 | Yes (X) | ||||
| JASON MCKEAN MD | |||||||||
| PHYSICIAN | 37.50 | $433,389 | $14,474 | $4,844 | Yes (X) | ||||
| LAWRENCE LAI MD | |||||||||
| PHYSICIAN | 37.50 | $429,893 | $0 | $69,839 | Yes (X) | ||||
| NATALYA CHERNICHENKO MD | |||||||||
| PHYSICIAN | 37.50 | $424,958 | $0 | $0 | Yes (X) | ||||
| STACEY SMITH MD | |||||||||
| PHYSICIAN | 37.50 | $417,873 | $0 | $24,300 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,778,036 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $8,296,425 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $654,476 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 96 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LOCUMTENENSCOM | |||||
| 2655 NORTHWINDS PARKWAY | ALPHARETTA | GA | 30009 | CONTRACT LABOR | $1,199,397 |
| ATHENAHEALTH | |||||
| 311 ARSENAL STREET | WATERTOWN | MA | 02472 | BILLING SERVICE | $957,856 |
| ADVANTEDGE HEALTHCARE SOLUTIONS | |||||
| 30 TECHNOLOGY DRIVE | WARREN | NJ | 07059 | BILLING SERVICES | $347,917 |
| CONIFER HEALTH SOLUTIONS | |||||
| 3560 DALLAS PARKWAY | FRISCO | TX | 75034 | BILLING SERVICES | $266,598 |
| HEALTHCARE TRANSITIONS MGMT | |||||
| ONE JOHN STREET 2ND FL STE 102 | BABYLON | NY | 11702 | BILLING SERVICE | $259,785 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $38,946,251 | $38,946,251 |
| CONTRACTED SERVICES AND OTHER | 621990 | $27,858,668 | $27,858,668 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $66,804,919 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,050 | TotalRevenueColumnAmt |
| Exclusion | $4,050 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $66,808,969 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $66,804,919 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,050 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,617,922 | TotalAmt |
| Program Services | $3,111,984 | ProgramServicesAmt |
| Management And General | $505,938 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,818,669 | TotalAmt |
| Program Services | $33,052,383 | ProgramServicesAmt |
| Management And General | $766,286 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,000 | TotalAmt |
| Program Services | $606,000 | ProgramServicesAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,700,508 | TotalAmt |
| Program Services | $2,422,005 | ProgramServicesAmt |
| Management And General | $278,503 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,100,709 | TotalAmt |
| Program Services | $2,024,692 | ProgramServicesAmt |
| Management And General | $76,017 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,324,783 | TotalAmt |
| Program Services | $2,324,783 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,956 | TotalAmt |
| Management And General | $86,956 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,992 | TotalAmt |
| Management And General | $146,992 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,905,919 | TotalAmt |
| Program Services | $10,333,223 | ProgramServicesAmt |
| Management And General | $1,572,696 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,206 | TotalAmt |
| Program Services | $17,322 | ProgramServicesAmt |
| Management And General | $17,884 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $768,994 | TotalAmt |
| Program Services | $754,832 | ProgramServicesAmt |
| Management And General | $14,162 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,789 | TotalAmt |
| Program Services | $45,664 | ProgramServicesAmt |
| Management And General | $25,125 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,739,106 | TotalAmt |
| Program Services | $1,602,334 | ProgramServicesAmt |
| Management And General | $136,772 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,362 | TotalAmt |
| Program Services | $241,756 | ProgramServicesAmt |
| Management And General | $4,606 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,696 | TotalAmt |
| Management And General | $41,696 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $304,451 | TotalAmt |
| Program Services | $247,900 | ProgramServicesAmt |
| Management And General | $56,551 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,101,862 | TotalAmt |
| Program Services | $6,028,069 | ProgramServicesAmt |
| Management And General | $73,793 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PRESIDENT'S TAX | $1,885,769 | $1,885,769 | |
| MEDICAL SUPPLIES | $929,068 | $905,067 | $24,001 |
| PROFESSIONAL DEV. | $348,306 | $227,876 | $120,430 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,795,067 | TotalAmt |
| Program Services | $65,831,659 | ProgramServicesAmt |
| Management And General | $3,963,408 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,795,883 | BOYAmt |
| EOY | $9,442,734 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,835,881 | BOYAmt |
| EOY | $4,528,030 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,554,890 | BOYAmt |
| EOY | $17,283,909 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,638 | BOYAmt |
| EOY | $134,198 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,674,933 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,513,348 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,242,752 | BOYAmt |
| EOY | $1,161,585 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,818,044 | BOYAmt |
| EOY | $32,550,456 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,433,876 | BOYAmt |
| EOY | $23,838,808 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,689,253 | BOYAmt |
| EOY | $515,258 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $999,720 | BOYAmt |
| EOY | $487,293 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,122,849 | BOYAmt |
| EOY | $24,841,359 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,695,195 | BOYAmt |
| EOY | $7,709,097 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,695,195 | BOYAmt |
| EOY | $7,709,097 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,818,044 | BOYAmt |
| EOY | $32,550,456 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$2,986,098 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,892,992 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,647,474 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,548,444 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $69,234,939 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,804,919 | CurrentTaxYearAmt |
| Total | $344,128,768 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,892,992 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,647,474 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,548,444 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $69,234,939 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,804,919 | CurrentTaxYearAmt |
| Total | $344,128,768 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $344,128,768 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,858 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,037 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,966 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $58,920 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,050 | CurrentTaxYearAmt |
| Total | $140,831 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,858 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,037 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $51,966 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $58,920 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,050 | CurrentTaxYearAmt |
| Total | $140,831 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $68,906,850 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,659,511 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $73,600,410 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $69,293,859 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,808,969 | CurrentTaxYearAmt |
| Total | $344,269,599 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99960 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99950 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00050 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,674,933 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,513,348 | DepreciationAmt |
| Book Value | $1,161,585 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,161,585 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (30 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM URBAN MD | ||||||||||||||
| PRESIDENT AND PHYSICIAN | $97,290 | $438,603 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $97,290 | $461,924 | $0 | $0 |
| DEBORAH REEDE MD | ||||||||||||||
| VICE-PRESIDENT AND PHYSICIAN | $193,750 | $557,859 | $0 | $0 | $6,181 | $24,500 | $0 | $0 | $0 | $9,315 | $199,931 | $591,674 | $0 | $0 |
| RICHARD ROSENFELD MD | ||||||||||||||
| SECRETARY/TREASURER AND PHYSICIAN | $118,955 | $485,758 | $0 | $0 | $0 | $18,500 | $0 | $0 | $0 | $0 | $118,955 | $504,258 | $0 | $0 |
| DAVID SCHWARTZ MD | ||||||||||||||
| DIRECTOR AND PHYSICIAN | $500,000 | $87,286 | $0 | $0 | $1,290 | $24,500 | $18,000 | $0 | $0 | $23,321 | $519,290 | $135,107 | $0 | $0 |
| JOHN DANIAS MD | ||||||||||||||
| DIRECTOR AND PHYSICIAN | $121,250 | $352,332 | $0 | $0 | $0 | $1,000 | $0 | $0 | $0 | $23,321 | $121,250 | $376,653 | $0 | $0 |
| MORO SALIFU MD | ||||||||||||||
| DIRECTOR AND ASSOCIATE PROFESSOR | $229,355 | $577,343 | $0 | $0 | $0 | $11,783 | $0 | $0 | $0 | $23,321 | $229,355 | $612,447 | $0 | $0 |
| MICHAEL LUCCHESI MD | ||||||||||||||
| DIRECTOR AND PHYSICIAN | $190,000 | $501,819 | $0 | $0 | $0 | $24,500 | $18,900 | $0 | $0 | $23,321 | $208,900 | $549,640 | $0 | $0 |
| ALEXANDER SCHWARTZMAN MD | ||||||||||||||
| PROFESSOR AND DIRECTOR | $188,255 | $322,336 | $0 | $0 | $0 | $22,318 | $3,850 | $0 | $0 | $23,321 | $192,105 | $367,975 | $0 | $0 |
| ALLA AKIVIS MD | ||||||||||||||
| DIRECTOR | $150,735 | $215,337 | $0 | $0 | $0 | $0 | $13,169 | $0 | $0 | $23,321 | $163,904 | $238,658 | $0 | $0 |
| AYMAN FANOUS MD | ||||||||||||||
| DIRECTOR | $0 | $309,265 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $0 | $332,586 | $0 | $0 |
| STANLEY FISHER MD | ||||||||||||||
| DIRECTOR AND PAST PRESIDEN | $0 | $430,192 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $0 | $453,513 | $0 | $0 |
| JENNY LIBIEM MD | ||||||||||||||
| DIRECTOR | $36,961 | $393,666 | $0 | $0 | $47 | $16,763 | $0 | $0 | $0 | $28,321 | $37,008 | $438,750 | $0 | $0 |
| DANIEL ROSENBAUM MD | ||||||||||||||
| DIRECTOR | $66,498 | $386,233 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $66,498 | $409,554 | $0 | $0 |
| STEPHEN WADOWSKI MD | ||||||||||||||
| DIRECTOR | $0 | $357,232 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $0 | $380,553 | $0 | $0 |
| AUDREE BENDO MD | ||||||||||||||
| DIRECTOR | $263,320 | $206,087 | $0 | $0 | $0 | $0 | $24,300 | $0 | $0 | $23,321 | $287,620 | $229,408 | $0 | $0 |
| RAINER GRUESSNER MD | ||||||||||||||
| DIRECTOR | $364,752 | $495,166 | $0 | $0 | $1,980 | $0 | $0 | $0 | $0 | $9,315 | $366,732 | $504,481 | $0 | $0 |
| CARLOS PATO MD | ||||||||||||||
| DIRECTOR | $0 | $685,363 | $0 | $0 | $0 | $18,500 | $0 | $0 | $0 | $9,315 | $0 | $713,178 | $0 | $0 |
| SIMON RABINOWITZ MD | ||||||||||||||
| DIRECTOR | $37,188 | $246,463 | $0 | $0 | $366 | $0 | $1,116 | $0 | $0 | $23,321 | $38,670 | $269,784 | $0 | $0 |
| ERIC SHRIER MD | ||||||||||||||
| DIRECTOR AND PHYSICIAN | $288,379 | $138,413 | $0 | $0 | $0 | $18,500 | $0 | $0 | $0 | $23,321 | $288,379 | $180,234 | $0 | $0 |
| LORI DONNELL | ||||||||||||||
| EXECUTIVE DIRECTOR | $136,298 | $125,856 | $0 | $0 | $943 | $0 | $0 | $0 | $2,843 | $0 | $140,084 | $125,856 | $0 | $0 |
| ALAN DZIJA | ||||||||||||||
| CFO | $247,349 | $0 | $0 | $0 | $6,182 | $0 | $0 | $0 | $0 | $0 | $253,531 | $0 | $0 | $0 |
| LAUREN GABELMAN | ||||||||||||||
| INTERIM COO | $50,000 | $149,456 | $0 | $0 | $137 | $0 | $1,371 | $0 | $0 | $0 | $51,508 | $149,456 | $0 | $0 |
| JOSEPH TESTANI | ||||||||||||||
| ADMINISTATOR | $106,538 | $172,632 | $0 | $0 | $1,078 | $0 | $2,550 | $0 | $0 | $9,322 | $110,166 | $181,954 | $0 | $0 |
| MARSHALL LIEBERMAN | ||||||||||||||
| ADMINISTATOR | $225,094 | $0 | $0 | $0 | $4,469 | $0 | $0 | $0 | $30,670 | $0 | $260,233 | $0 | $0 | $0 |
| ROSS CLINCHY | ||||||||||||||
| EXECUTIVE DIRECTOR (THRU MAR. 2018) | $0 | $288,414 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,321 | $0 | $311,735 | $0 | $0 |
| ROMAN SHINDER MD | ||||||||||||||
| PHYSICIAN | $437,271 | $0 | $0 | $0 | $12 | $0 | $0 | $0 | $0 | $0 | $437,283 | $0 | $0 | $0 |
| JASON MCKEAN MD | ||||||||||||||
| PHYSICIAN | $433,008 | $14,474 | $0 | $0 | $381 | $0 | $0 | $0 | $4,844 | $0 | $438,233 | $14,474 | $0 | $0 |
| LAWRENCE LAI MD | ||||||||||||||
| PHYSICIAN | $428,783 | $0 | $0 | $0 | $1,110 | $0 | $24,300 | $0 | $45,539 | $0 | $499,732 | $0 | $0 | $0 |
| NATALYA CHERNICHENKO MD | ||||||||||||||
| PHYSICIAN | $424,958 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $424,958 | $0 | $0 | $0 |
| STACEY SMITH MD | ||||||||||||||
| PHYSICIAN | $409,767 | $0 | $0 | $0 | $8,106 | $0 | $24,300 | $0 | $0 | $0 | $442,173 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAUREN GABELMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE SCH L. PART V | RelationshipDescriptionTxt |
| Transaction | $50,137 | TransactionAmt |
| Transaction | EMPLOYMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH L, PART IV, COLUMN (B) | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION:FAMILY MEMBER OF WILLAM URBAN, MD, BOARD PRESIDENT. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. THE MEMBERS VOTE FOR OFFICERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS VOTE FOR OFFICERS AND THE PRESIDENT CAN APPOINT AN OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE UNIVERSITY PHYSICIANS OF BROOKLYN, INC. BOARD OF DIRECTORS DID NOT REVIEW THE RETURN PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE EMPLOYEES OF THE STATE UNIVERSITY OF NEW YORK. AS NOTED IN THE MISSION STATEMENT, UPB PROVIDES SERVICES AND SUPPORT TO THE OBJECTIVES OF SUNY. AS THE BOARD MEMBERS ARE EMPLOYEES OF SUNY, UPB HONORS THE CONFLICT OF INTEREST STATEMENTS MAINTAINED BY THEIR COMPLIANCE DEPARTMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST FROM THE ORGANIZATION. |
| FORM 990, PART IX, LINE 11G | CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 10,333,223. MANAGEMENT AND GENERAL EXPENSES 997,104. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,330,327. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 575,592. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 575,592. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT AND OVERSIGHT OF FINANCIAL STATEMENT FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | EINEIN | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SUNY HEALTH SCIENCE CENTER AT BROOKLYN DBA SUNY DOWNSTATE MEDICAL CENTER | |||||||||||
| 450 CLARKSON AVENUE | BROOKLYN | NY | 11203 | COLLEGE OF MEDICINE AND HEALTH SCIENCES | NY | N/A | 0 | ||||
| THE HEALTH SCIENCE CENTER AT BROOKLYN FOUNDATION INC | |||||||||||
| 450 CLARKSON AVENUE | BROOKLYN | NY | 11203 | TO AID THE STUDENTS AND FACULTY OF SUNY DOWNSTATE | NY | 0 | 112418771 | 501(C)(3) | 7 | SUNY DOWNSTATE | |
| FACULTY STUDENT ASSOCIATION OF DOWNSTATE MEDICAL CENTER INC | |||||||||||
| 450 CLARKSON AVENUE | BROOKLYN | NY | 11203 | TO PROVIDE EDUCATIONALLY RELATED AUXILIARY SERVICES | NY | 0 | 111704590 | 501(C)(3) | 9 | SUNY DOWNSTATE | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |