PHYSICIANS OF UNIVERSITY HOSPITAL PC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- PHYSICIANS OF UNIVERSITY HOSPITAL PC (EIN 20-0096809)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201743189349302624
- Schema version
- 2016v3.1
- 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 | 2017-11-14T10:15:09-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200096809 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PHYSICIANS OF UNIVERSITY HOSPITAL PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % NORTHWELL HEALTH INC | InCareOfNm |
| Business Name Control | PHYS | BusinessNameControlTxt |
| Phone | 5163216025 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 972 BRUSH HOLLOW ROAD Suite 5TH FLR | AddressLine1Txt |
| City | WESTBURY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11590 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT S SHAPIRO | PersonNm |
| Person Title | EVP & CFO | PersonTitleTxt |
| Signature | 2017-11-03 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.27.229.129 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 26440820173185000000 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-14 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 64888C196846E503F90B13161ED1827B039267C6 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 08A1259C5F1059ABDC7B7C0B44F2F73D70A20910 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BRAHIM ARDOLIC | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 475 seaview avenue | AddressLine1Txt |
| City | staten island | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10305 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $172,583,265 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHWELL.EDU | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES IN FURTHERANCE OF THE CHARITABLE PUR- POSES OF SIUH; A RELATED IRC SECTION 501(C)(3) TAX-EXEMPT HOSPITAL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 2 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 378 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $154,679,969 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $170,409,654 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,998 | PYOtherRevenueAmt |
| CY Other Revenue | $2,173,611 | CYOtherRevenueAmt |
| PY Total Revenue | $154,681,967 | PYTotalRevenueAmt |
| CY Total Revenue | $172,583,265 | 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 | $127,143,451 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $143,605,712 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $27,682,378 | PYOtherExpensesAmt |
| CY Other Expenses | $30,474,010 | CYOtherExpensesAmt |
| PY Total Expenses | $154,825,829 | PYTotalExpensesAmt |
| CY Total Expenses | $174,079,722 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$143,862 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,496,457 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,784,719 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,680,610 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,650,021 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $14,042,369 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,134,698 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,638,241 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES IN FURTHERANCE OF THE CHARITABLE PURPOSES OF STATEN ISLAND UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) TAX-EXEMPT HOSPITAL WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES TO ALL INDIVIDUALS IN A NON-DISCRIMINATORY MANNER REGARDLESS OF RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $158,107,278 | ExpenseAmt |
| Revenue | $170,409,654 | RevenueAmt |
| Desc | EXPENSES INCURRED ACTING IN FURTHERANCE OF THE CHARITABLE PURPOSES OF STATEN ISLAND UNIVERSITY HOSPITAL; A RELATED INTERNAL REVENUE CODE SECTION 501(C)(3) tax-exempt hospital WHICH PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES to all individuals in a non-discriminatory manner regardless of RACE, COLOR, CREED, SEX, NATIONAL ORIGIN, RELIGION OR ability to pay. | Desc |
| Total Program Service Expenses | $158,107,278 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 378 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 2 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NORTHWELL HEALTH INC | PersonNm |
| Phone | 5168766061 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 972 BRUSH HOLLOW ROAD | AddressLine1Txt |
| City | WESTBURY | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11590 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BRAHIM ARDOLIC MD | ||||||||
| CHAIR/DIR, RESEARCH & MED | 0.0 | 50.0 | Yes (X) | Yes (X) | $0 | $608,690 | $55,729 | |
| FRANK FORTE | ||||||||
| SECRETARY - TRUSTEE | 0.0 | 50.0 | Yes (X) | Yes (X) | $0 | $519,941 | $47,132 | |
| NICOLE BERWALD MD | ||||||||
| ASSOC CHAIRPERSON | 50.0 | 0.0 | $397,645 | $0 | $55,729 | Yes (X) | ||
| BORIS KHODORKOVSKY MD | ||||||||
| ASSOC CHAIRPERSON | 50.0 | 0.0 | $407,850 | $0 | $55,729 | Yes (X) | ||
| CHRISTOPHER GRAZIANO MD | ||||||||
| ASSOC MEDICAL DIRECTOR | 50.0 | 0.0 | $377,668 | $0 | $55,729 | Yes (X) | ||
| MOSHE WEIZBERG | ||||||||
| ASSOC CHAIRPERSON | 50.0 | 0.0 | $422,693 | $0 | $29,750 | Yes (X) | ||
| NIMA MAJLESI | ||||||||
| PHYSICIAN | 50.0 | 0.0 | $364,698 | $0 | $29,750 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,970,554 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,128,631 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $329,548 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 98 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDAPTUS INC | |||||
| 176 FEDERAL STREET | BOSTON | MA | 02110 | IT SERVICES | $286,921 |
| KING CLEAN | |||||
| 150 L GREAVES LANE B105 | STATEN ISLAND | NY | 10308 | JANITORIAL services | $195,431 |
| LLOYD STAFFING INC | |||||
| 445 BROADHOLLOW ROAD | MELVILLE | NY | 11747 | NURSING FEES | $160,754 |
| FIFTEEN DEGREES LLC | |||||
| 27 EAST 21ST ST 2ND FL | NEW YORK | NY | 10010 | ADVERTISING | $142,668 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621300 | $91,042,674 | $91,042,674 |
| OTHER HEALTHCARE RELATED REVENUE | 621300 | $79,366,980 | $79,366,980 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $170,409,654 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,060 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $47,060 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,060 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAPITATION INCOME | 900099 | $541,353 | $541,353 |
| QUALITY MANAGEMENT REVENUE | 900099 | $6,775 | $6,775 |
| CONTRACT INCOME | 900099 | $3,445 | $3,445 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,574,978 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,574,978 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,126,551 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,583,265 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $172,536,205 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,708,552 | TotalAmt |
| Program Services | $111,337,696 | ProgramServicesAmt |
| Management And General | $12,370,856 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,377,762 | TotalAmt |
| Program Services | $3,939,986 | ProgramServicesAmt |
| Management And General | $437,776 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,190,106 | TotalAmt |
| Program Services | $9,171,095 | ProgramServicesAmt |
| Management And General | $1,019,011 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,329,292 | TotalAmt |
| Program Services | $4,796,363 | ProgramServicesAmt |
| Management And General | $532,929 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,772 | TotalAmt |
| Management And General | $499,772 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,207 | TotalAmt |
| Management And General | $9,207 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $919,173 | TotalAmt |
| Program Services | $827,256 | ProgramServicesAmt |
| Management And General | $91,917 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,751 | TotalAmt |
| Program Services | $6,976 | ProgramServicesAmt |
| Management And General | $775 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,291,002 | TotalAmt |
| Program Services | $3,861,902 | ProgramServicesAmt |
| Management And General | $429,100 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,009,972 | TotalAmt |
| Program Services | $2,708,975 | ProgramServicesAmt |
| Management And General | $300,997 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,377 | TotalAmt |
| Program Services | $43,377 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,238 | TotalAmt |
| Program Services | $50,238 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,552 | TotalAmt |
| Program Services | $247,097 | ProgramServicesAmt |
| Management And General | $27,455 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,972,491 | TotalAmt |
| Program Services | $14,972,491 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BILLING & COLLECTION | $3,869,988 | $3,869,988 | |
| OTHER EXPENSES | $2,213,001 | $1,991,701 | $221,300 |
| DUES & SUBSCRIPTIONS | $313,486 | $282,137 | $31,349 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,079,722 | TotalAmt |
| Program Services | $158,107,278 | ProgramServicesAmt |
| Management And General | $15,972,444 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,118,389 | BOYAmt |
| EOY | $5,769,756 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,235,252 | BOYAmt |
| EOY | $14,938,795 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $729,984 | BOYAmt |
| EOY | $876,035 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,622,435 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $556,411 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $403,188 | BOYAmt |
| EOY | $1,066,024 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,297,906 | BOYAmt |
| EOY | $6,030,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,784,719 | BOYAmt |
| EOY | $28,680,610 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,650,021 | BOYAmt |
| EOY | $12,105,898 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,936,471 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,650,021 | BOYAmt |
| EOY | $14,042,369 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,134,698 | BOYAmt |
| EOY | $14,638,241 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,134,698 | BOYAmt |
| EOY | $14,638,241 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,784,719 | BOYAmt |
| EOY | $28,680,610 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,496,457 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $5,000,000 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supporting Organization509a3 | Yes (X) | SupportingOrganization509a3Ind |
| Supporting Org Type1 | Yes (X) | SupportingOrgType1Ind |
| IRS Written Determination | Yes (X) | IRSWrittenDeterminationInd |
| Supported Organizations | 1 | SupportedOrganizationsCnt |
Supported Org Information SupportedOrgInformationGrp
Supported Organization Name SupportedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STATEN ISLAND UNIVERSITY HOSPITAL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 112868878 | EIN |
| Organization Type | 3 | OrganizationTypeCd |
| Governing Document Listed | Yes (true) | GoverningDocumentListedInd |
| Support | $0 | SupportAmt |
| Other Support | $0 | OtherSupportAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Supported Organizations Total | 1 | SupportedOrganizationsTotalCnt |
| Support Sum | $0 | SupportSumAmt |
| Other Support Sum | $0 | OtherSupportSumAmt |
Form990 Sch A Supporting Org Form990SchASupportingOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Listed By Name Governing Doc | Yes (true) | ListedByNameGoverningDocInd |
| Suprt Org No IRS Determination | false | SuprtOrgNoIRSDeterminationInd |
| Supported Org Section C456 | false | SupportedOrgSectionC456Ind |
| Supported Org Not Organized US | false | SupportedOrgNotOrganizedUSInd |
| Organization Change Suprt Org | false | OrganizationChangeSuprtOrgInd |
| Support Non Supported Org | false | SupportNonSupportedOrgInd |
| Payment Substantial Contribtr | false | PaymentSubstantialContribtrInd |
| Loan Disqualified Person | false | LoanDisqualifiedPersonInd |
| Controlled Disqualified Prsn | false | ControlledDisqualifiedPrsnInd |
| Disqualified Prsn Controll Int | false | DisqualifiedPrsnControllIntInd |
| Disqualified Prsn Ownr Int | false | DisqualifiedPrsnOwnrIntInd |
| Excess Business Holdings Rules | false | ExcessBusinessHoldingsRulesInd |
| Contribution Controller | false | ContributionControllerInd |
| Contribution Family | false | ContributionFamilyInd |
| Contribution35 Controlled | false | Contribution35ControlledInd |
Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Power Appoint Majority Dir Trst | Yes (true) | PowerAppointMajorityDirTrstInd |
| Operate Benefit Non Suprt Org | false | OperateBenefitNonSuprtOrgInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $298,292 | OtherCostOrOtherBasisAmt |
| Depreciation | $298,292 | DepreciationAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $58,822 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,941 | DepreciationAmt |
| Book Value | $55,881 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,266,942 | OtherCostOrOtherBasisAmt |
| Depreciation | $255,178 | DepreciationAmt |
| Book Value | $1,011,764 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | -$1,621 | OtherCostOrOtherBasisAmt |
| Book Value | -$1,621 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,066,024 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER ASSETS | $30,000 |
| INVESTMENT IN ACQUIRED ENTITY | $1,000,000 |
| GOODWILL | $5,000,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,030,000 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $1,936,471 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,936,471 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $158,232,854 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $158,232,854 | RevenueSubtotalAmt |
| Other Revenues Not Included | $14,350,411 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $14,350,411 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $172,583,265 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $159,729,312 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$14,350,410 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$14,350,410 | ExpensesNotReportedAmt |
| Expenses Subtotal | $174,079,722 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $174,079,722 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2 | Certain entities included in Northwells consolidated financial statements are taxable entities under Federal or state laws. U.S. generally accepted accounting principles require that the asset and liability method of accounting for income taxes be utilized by these organizations and for unrelated business activities for the tax-exempt entities. Under the asset and liability method, deferred income taxes are recognized for the tax consequences of temporary differences by applying enacted statutory tax rates applicable to future years to differences between the financial statement carrying amounts and the tax basis of existing assets and liabilities. The effect on deferred taxes of a change in tax rates is recognized in income in the period of enactment. At December 31, 2016 and 2015, Northwell has a deferred income tax asset which has been fully offset by a related valuation allowance. A valuation allowance is provided when it is more likely than not that some portion or all of the deferred tax asset will not be realized. Significant components of the deferred tax asset relate to the allowance for doubtful accounts and net operating loss carryforwards. Certain entities have net operating loss carryforwards aggregating approximately $408,000,000, which expire in varying amounts through 2036, and are available to offset future taxable income. |
| PART XI, LINE 4B | RECONCILIATION OF REVENUE PHYSICIAN SERVICES RECLASS 14,350,411 |
| PART XII, LINE 2D | RECONCILIATION OF EXPENSE PHYSICIAN SERVICES RECLASS 14,350,410 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRAHIM ARDOLIC MD | ||||||||||||||
| CHAIR/DIR, RESEARCH & MED | $0 | $519,849 | $0 | $61,889 | $0 | $26,952 | $0 | $29,150 | $0 | $26,579 | $0 | $664,419 | $0 | $0 |
| FRANK FORTE | ||||||||||||||
| SECRETARY - TRUSTEE | $0 | $494,199 | $0 | $25,000 | $0 | $742 | $0 | $29,150 | $0 | $17,982 | $0 | $567,073 | $0 | $0 |
| NICOLE BERWALD MD | ||||||||||||||
| ASSOC CHAIRPERSON | $336,072 | $0 | $57,960 | $0 | $3,613 | $0 | $29,150 | $0 | $26,579 | $0 | $453,374 | $0 | $0 | $0 |
| BORIS KHODORKOVSKY MD | ||||||||||||||
| ASSOC CHAIRPERSON | $339,517 | $0 | $54,923 | $0 | $13,410 | $0 | $29,150 | $0 | $26,579 | $0 | $463,579 | $0 | $0 | $0 |
| CHRISTOPHER GRAZIANO MD | ||||||||||||||
| ASSOC MEDICAL DIRECTOR | $309,039 | $0 | $46,666 | $0 | $21,963 | $0 | $29,150 | $0 | $26,579 | $0 | $433,397 | $0 | $0 | $0 |
| MOSHE WEIZBERG | ||||||||||||||
| ASSOC CHAIRPERSON | $356,874 | $0 | $55,928 | $0 | $9,891 | $0 | $29,150 | $0 | $600 | $0 | $452,443 | $0 | $0 | $0 |
| NIMA MAJLESI | ||||||||||||||
| PHYSICIAN | $281,875 | $0 | $36,285 | $0 | $46,538 | $0 | $29,150 | $0 | $600 | $0 | $394,448 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | ON FORM 990, PART VII, SECTION A, LINE 1A, THE ORGANIZATION MAY PROVIDE NON-FIXED PAYMENTS, NOT DESCRIBED ON LINES 5 AND 6, TO CERTAIN LISTED PERSONS. THE ORGANIZATION BASES SUCH PAYMENTS ON MANY PERFORMANCE BASED FACTORS. PAYMENTS OF THIS TYPE APPEAR ON SCHEDULE J-1, PART I, B (II). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART VI, SECTION A - GOVERNING BODY, LINE 7 | Staten Island University Hospital is the sole member of this organization which exists through a physician nominee agreement due to state of new york corporate practice of medicine rules and regulations. NORTHWELL HEALTHCARE, INC. ("Healthcare") is the sole member of Staten Island University Hospital. Health Care has the right to elect or appoint members of the organization's governing body and has the right to approve or ratify certain corporate decisions. This organization and Health Care are part of the NORTHWELL HEALTH, INC., an integrated health care delivery system. |
| PART VI, SECTION B-POLICIES, LINE 11 | The annual Return of Organization Exempt From Income Tax (Form 990) for Northwell Health, Inc. and Affiliated entities are prepared with input from various departments including Corporate Compliance, Finance, Human Resources, and Legal. Before filing the returns, the documents are electronically made available to all trustees through a secure online portal. Members of the Executive Committee are then informed the returns are ready for review. The Executive Committee, which is a committee made up of members from the Board of Trustees, may exercise all of the authority of the Board of Trustees except as such authority is limited by applicable law and except to the extent, if any, that such authority would be inconsistent with any provision of these By-laws or is limited by any resolution to such effect adopted by the Board of Trustees. |
| PART VI, SECTION B-POLICIES, LINE 12C | Northwell Health, Inc. ("Northwell") has several control mechanisms to mitigate conflicts of interest. Northwells Code of Ethical Conduct contains a detailed section educating individuals about how to avoid potential conflicts of interest. Specifically, our Code of Ethical Conduct requires individuals to conduct Northwell business in a manner that places the interests of Northwell ahead of their personal interests. In addition, Northwell has a Conflicts of Interest Policy Statement further elaborating upon individuals' disclosure and recusal obligations. Individuals that are in a position to influence the business or other decisions of Northwell are required to fill out a conflicts of interest disclosure form on a regular basis. The Corporate Compliance Office reviews all disclosures of possible conflicts, including matters disclosed in any conflicts of interest disclosure report and takes any actions deemed required or appropriate to manage or resolve any actual or potential conflicts of interest. In appropriate cases these disclosures and responsive actions will be reported to Northwells Audit and Corporate Compliance Committee and other applicable committees. In addition, Northwell provides training to individuals on an annual basis regarding conflicts of interest and other compliance related topics. If an individual violates the Code of Ethical Conduct or any related policy such as the Conflicts of Interest Policy Statement, appropriate disciplinary action is taken based upon the facts and circumstances of the situation. |
| PART VI, SECTION B-POLICIES, LINE 15 | The by-laws of Northwell Health, Inc. ("Northwell") create a committee of the board with full powers of the board to review and approve the compensation of officers and other key employees. The committee consists of approximately 6 trustees who have no connection to Northwell except as trustees and they have no conflicts as to matters they consider. The committee meets several times a year as needed but always meets in November/December to review and determine officer and key employee compensation for the following year. For purposes of their review the committee considers the recommendations of the CEO for all persons other than the CEO. For purposes of the review each year the committee receives information from an outside independent compensation consultant as to compensation for comparable positions in comparable organizations and makes its decisions on this basis, with the overall objective of paying base salary at the 50th percentile. Any contracts or other compensation for officers or key employees are separately considered and normally only approved after receipt of a "fairness opinion" from the independent consultant. All the work and process of the committee is structured to fall within the applicable safe harbor regulations. |
| PART VI, SECTION C-DISCLOSURES, LINE 19 | CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST. |
| PART VII, SECTION A - LINE 1A, COLUMN (B) | This organization is affiliated with Northwell Health, Inc. ("Northwell"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of Northwell, and they do not separately allocate their time to this organization and such other affiliates. The hours shown for all such persons reflect time devoted to Northwell and its affiliates, including this organization. For Directors and Trustees, the hours shown reflect the estimated average weekly time. For officers, Key Employees and Highest Compensated Employees, the hours shown reflect the weekly hours used when determining compensation payments for services rendered and are, generally, less than the actual weekly hours devoted to Northwell and its affiliates. |
| PART XI, LINE 9 | PURCHASE OF UNIVERSITY PHYSICIAN GROUP $5,000,000 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (50 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| Feinstein Institute for Medical Research | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112673595 | Research | NY | 501(C)(3) | 4 | NW HEALTH | false |
| Glen Cove Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111633487 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| Hillside Hospital Houses Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112113949 | Housing Comp | NY | 501(C)(2) | N/A | NW HEALTH | false |
| Hospice Care Network | ||||||||||
| 99 Sunnyside Boulevard | Woodbury | NY | 11797 | 112925757 | Hospice | NY | 501(C)(3) | 9 | NW HEALTH | false |
| Huntington Hospital | ||||||||||
| 270 Park Avenue | Huntington | NY | 11743 | 111630914 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| Huntington Hosp Dolan Family Health Ctr | ||||||||||
| 284 Pulaski Road | Greenlawn | NY | 11740 | 113368503 | HealthCare | NY | 501(C)(3) | 3 | Huntington | false |
| LIJ Foundation | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112661239 | support org | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| Long Island Jewish Medical Center | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112241326 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| LIJ Medical Center at Home Pharmacy | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113251128 | support org | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| North Shore Community Services Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237273200 | Housing Comp | NY | 501(C)(2) | N/A | NW HEALTH | false |
| North Shore University Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111562701 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| NS Univ Hospital at Glen Cove Housing | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237010468 | Housing Comp | NY | 501(C)(2) | N/A | NW HEALTH | false |
| North Shore University Hospital Housing | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112171903 | Housing Comp | NY | 501(C)(2) | N/A | NW HEALTH | false |
| NORTHWELL HEALTH STERN FAMILY CENTER FOR | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 237007485 | Nursing Home | NY | 501(C)(3) | 9 | NW HEALTHCAR | false |
| NORTHWELL HEALTHCARE Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112965586 | support org | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| NORTHWELL HEALTH INC | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113418133 | support org | NY | 501(C)(3) | 11, TYPE I | NA | false |
| NORTHWELL Health Foundation | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112965575 | Fundraising | NY | 501(C)(3) | 7 | NW HEALTH | false |
| NORTHWELL HEALTH Laboratories | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113412370 | support org | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| North Shore-LIJ Medical Care Centers | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113473923 | support org | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| Plainview Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113241243 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| SIUH Systems Inc | ||||||||||
| 475 Seaview Avenue | Staten Island | NY | 10305 | 061074604 | Fundraising | NY | 501(C)(3) | 7 | NW HEALTHCAR | false |
| Southside Hospital | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 111667761 | HealthCare | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| SSH Inc | ||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112774102 | support org | NY | 501(C)(3) | 11, TYPE I | SOUTHSIDE | false |
| Staten Island Univ Hospital Foundation | ||||||||||
| 360 Seaview Avenue | Staten Island | NY | 10305 | 870765787 | Fundraising | NY | 501(C)(3) | 7 | SIUH | false |
| THE HEART INSTITUTE | ||||||||||
| 475 SEAVIEW AVENUE | STATEN ISLAND | NY | 10305 | 311757254 | SUPPORT ORG | NY | 501(C)(3) | 11, TYPE I | NA | false |
| LENOX HILL HOSPITAL | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 131624070 | HEALTHCARE | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| LHH CORPORATION | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133272016 | SUPPORT ORG | NY | 501(C)(3) | 11, TYPE I | NW HEALTH | false |
| STATEN ISLAND UNIVERSITY HOSPITAL | ||||||||||
| 475 Seaview Avenue | STATEN ISLAND | NY | 10305 | 112868878 | HEALTHCARE | NY | 501(C)(3) | 3 | NW HEALTH | false |
| THE ELMEZZI GRAD SCHOOL OF MOLECULAR MED | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 113284934 | GRADUATE SCH | NY | 501(C)(3) | 2 | RESEARCH | false |
| SPORTS PHYSICAL THERAPY AND REHAB SVCS | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 061655704 | HEALTHCARE | NY | 501(C)(3) | 9 | LIJ | false |
| NORTH SHORE - LIJ ALLIANCE | ||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 263727582 | HEALTHCARE | NY | 501(C)(3) | 3 | NA | false |
| THE LONG ISLAND HOME | ||||||||||
| 400 SUNRISE HIGHWAY | AMITYVILLE | NY | 11701 | 112837244 | HEALTHCARE | NY | 501(c)(3) | 3 | LHH CORP | false |
| CLNY ALLIANCE INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 463146870 | LABORATORY | NY | 501(c)(3) | 3 | NW LABS | false |
| NORTH SHORE-LIJ CARDIO MEDICINE PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078717 | MEDICAL SVCS. | NY | 501(C)(3) | 11, TYPE I | NSUH | false |
| NORTH SHORE-LIJ CARDIO AT DEER PARK PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078531 | MEDICAL SVCS. | NY | 501(C)(3) | 11, TYPE I | NSUH | false |
| NORTH SHORE-LIJ HEART SURGERY PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078838 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE I | NSUH | false |
| NORTH SHORE-LIJ INTERNAL MEDICINE PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078631 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE I | NSUH | false |
| NORTH SHORE-LIJ MED GROUP URG MED CARE | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 275078426 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE I | NSUH | false |
| NORTH SHORE-LIJ MEDICAL PC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 453023019 | MEDICAL SVCS. | NY | 501(c)(3) | 11, TYPE 1 | NSUH | false |
| NORTH SHORE-LIJ HEALTH PLAN INC | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 461617516 | INSURANCE | NY | 501(C)(3) | 9 | HPLAN HOLDIN | false |
| Advocate Community Providers | ||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 472528627 | DSRIP | NY | 501(C)(3) | 7 | NA | false |
| North Shore-LIJ Health Plan Holding Comp | ||||||||||
| 972 Brush Hollow Rd | WESTBURY | NY | 11590 | 462478147 | HOLDING CO | NY | 501(C)(3) | 11, TYPE II | NW HEALTHCAR | false |
| Phelps Memorial Hospital Association | ||||||||||
| 701 North Broadway | SLEEPY HOLLOW | NY | 10591 | 131725076 | HOSPITAL | NY | 501(c)(3) | 3 | NW HEALTHCAR | false |
| Phelps Medical Services PC | ||||||||||
| 701 North Broadway | Sleepy Hollow | NY | 10591 | 274416017 | MEDICAL SVCS | NY | 501(C)(3) | 11, TYPE I | PHELPS MEMOR | false |
| Northern Westchester Hospital Associatio | ||||||||||
| 400 East Main Street | Mount Kisco | NY | 10549 | 131740118 | HOSPITAL | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| Northern Westchester Hospital Foundation | ||||||||||
| 400 East Main Street | mount Kisco | NY | 10549 | 134067064 | FOUNDATION | NY | 501(C)(3) | 9 | NWHA | false |
| NORCORP Inc | ||||||||||
| 400 East Main Street | Mount Kisco | NY | 10549 | 133366748 | Support Org | NY | 501(C)(3) | 11, TYPE I | NWHA | false |
| Northern Westchester Realty Holding Comp | ||||||||||
| 400 East Main Street | Mount Kisco | NY | 10549 | 912134215 | HOLDING CO | NY | 501(C)(2) | N/A | NWHA | false |
| CENTRAL SUFFOLK HOSPITAL ASSOCIATION | ||||||||||
| 1300 ROANOKE AVE | RIVERHEAD | NY | 11901 | 111661359 | HEALTH CARE | NY | 501(C)(3) | 3 | NW HEALTHCAR | false |
| STATEN ISLAND PERFORMING PROVIDER SYSTEM | ||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 472544659 | DSRIP | NY | APPLIED FOR | NA | false | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|
| KRASNOFF CONS SVCS | |||||||
| 972 Brush Hollow ROAD | WESTBURY | NY | 11590 | 262838027 | CONSULTING | NY | CARE MGT GROUP |
| ENDOSCOPY CTR OF LI | |||||||
| 972 BRUSH HOLLoW ROAD | WESTBURY | NY | 11590 | 260000980 | MEDICAL SVCS. | NY | NS-LIJ VENTURES |
| TRUE NORTH URG CARE | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464113494 | MEDICAL SVCS. | NY | NS-LIJ URG CARE |
| TRUE NORTH DC | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464601950 | MEDICAL SVCS. | NY | RENAL VENTURES |
| SYN HLTH TRUE NORTH | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464106483 | MEDICAL SVCS. | NY | CENTRAL STERILE |
| NORTH SHORE-LIJ and yale new haven medic | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464858222 | AIR TRANSPORT | NY | NSUH |
| NORTH SHORE-LIJ CONTRACT RESEARCH ORGANI | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 464469806 | RESEARCH | NY | HEALTH CARE |
| NORTH SHORE-LIJ RENAL VENTURES LLC | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 463869336 | MEDICAL SVCS | NY | NSUH |
| NASSAU QUEENS PERFORMING PROVIDER SYSTEM | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 472544821 | DSRIP | NY | NSUH |
| Endo Group LLC | |||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 200248148 | Medical Svcs | NY | ventures gcsc |
| Hospital City LLC | |||||||
| 972 Brush Hollow Rd | Westbury | NY | 11590 | 474091780 | inactive | DE | northwell healt |
| Northwell Genomic Alliance LLC | |||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 810826710 | inactive | NY | NW labs |
| Health Connect Technologies LLC | |||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 810967200 | inactive | NY | newport health |
| Phelps Professional Building Corp LP | |||||||
| 777 North Broadway | Sleepy Hollow | NY | 10591 | 133645137 | real estate | NY | pmha |
| OPTUM 360 LLC | |||||||
| 11000 OPTUM CIRCLE | EDEN PRAIRIE | MN | 55344 | 463328307 | BILLING | MN | OPTUM |
| BROOKLYN MANAGEMENT SERVICES ORGANIZATIO | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 812910850 | MEDICAL SVCS | NY | NORTHWELL HEALT |
| SOUTH SHORE SURGERY CENTER LLC | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 341997077 | MEDICAL SVCS | NY | MULTISPECIALTY |
| FORMATIV HEALTH LLC | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813121231 | HOLDING CO | DE | MAGNITUDE HOLD |
| FORMATIV HEALTH INTERMEDIATE LLC | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 814614788 | HOLDING CO | DE | FORM HLTH HOLD |
| SUFFOLK SURGERY CENTER | |||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 200080609 | MEDICAL SVCS | NY | MULTISPECIALTY |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (61 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd | Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | Province Or StateForeignAddress/ProvinceOrStateNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Aletta Corporation | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 112622371 | Physician SVC | NY | SOUTHSIDE | C CORPORATION | false | ||||||
| Autoimmune Research Therapeutics | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 270701489 | Inactive | NY | RESEARCH | C CORPORATION | false | ||||||
| Care Management Group of Greater NY | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113336381 | Business Serv | NY | NSH ENTERPRISES | C CORPORATION | false | ||||||
| Lenox Hill Pathology PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133644370 | Medical Servi | NY | LENOX HILL | C CORPORATION | false | ||||||
| Lenox otolaryngology head & neck | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 208784395 | Medical Servi | NY | LENOX HILL | C CORPORATION | false | ||||||
| North Shore Health Enterprises | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 061605319 | Holding Comp | NY | NSHS ENTERPRISE | C CORPORATION | false | ||||||
| NS Health System Enterprises | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113316922 | Holding Comp | NY | NW HEALTH | C CORPORATION | false | ||||||
| North Shore IPA 5 Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113383468 | Business Serv | NY | NW HEALTHCARE | C CORPORATION | false | ||||||
| NS Radiology at Glen Cove PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113301179 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #1 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533659 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Health System IPA #2 | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113533670 | HealthCare | NY | LIJ | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at Huntington PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384049 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at North Nassau PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384146 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Gr at Syosset PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 273957752 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Medical Group PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384249 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ Network Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 320257193 | Support Servi | NY | NW HEALTH | C CORPORATION | false | ||||||
| North Shore-LIJ Physicians Group PC | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 274384326 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| North Shore-LIJ Service Alliance Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 263651575 | Support Servi | NY | NA | C CORPORATION | false | ||||||
| Regional Insurance Company LTD | |||||||||||||||
| 000000000 | insurance | NW HEALTHCARE | C CORPORATION | false | 41 Cedar Ave | Hamilton | BERMUDA | BD | HM 12 | BD | |||||
| Regioncare Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 113052191 | Homecare | NY | NSHS ENTERPRISE | C CORPORATION | false | ||||||
| SIUH Perinatology PC | |||||||||||||||
| 475 Seaview Avenue | Staten Island | NY | 10305 | 134107082 | Medical Servi | NY | SIUH | C CORPORATION | false | ||||||
| United Medical Surgical PC | |||||||||||||||
| 256 Mason Avenue BLDG B 2nd FL | Staten Island | NY | 10305 | 134038780 | Surgical Serv | NY | SIUH | S CORPORATION | false | ||||||
| Vivohealth Inc | |||||||||||||||
| 972 Brush Hollow Road | Westbury | NY | 11590 | 264118016 | Inactive | NY | NSH ENTERPRISE | C CORPORATION | false | ||||||
| LENOX HILL HOSPITAL MEDICAL PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 452661543 | Medical Servi | NY | lenox | C CORPORATION | false | ||||||
| NS-LIJ OCCUPATIONAL MEDICINE PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 451004103 | Medical Servi | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ OB-GYN PC | |||||||||||||||
| 972 Brush Hollow Road | WESTBURY | NY | 11590 | 461382916 | Medical Servi | NY | lij | c corporation | false | ||||||
| NS-LIJ ANESTHESIOLOGY PC | |||||||||||||||
| 972 BRUSH HOLLOW Road | WESTBURY | NY | 11590 | 461617561 | Medical Servi | NY | SOUTHSIDE | C CORPORATION | false | ||||||
| NS-LIJ INTERNAL MEDICINE AT LYNBROOK PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 463475908 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ INTERNAL MEDICINE NEW HYDE PARK | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462822879 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| NS-LIJ OB-GYN AT GARDEN CITY PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462886776 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| CARECONNECT INSURANCE COMPANY | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 462270382 | INSURANCE | NY | group holding | C CORPORATION | false | ||||||
| NORTH SHORE MEDICAL ACCELERATOR PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | Westbury | NY | 11590 | 112945979 | MEDICAL SERVI | NY | nsuh | S CORPORATION | false | ||||||
| TRUE NORTH HEALTH PHARMACY INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 471020508 | PHARMACY | NY | NSUH | C CORPORATION | false | ||||||
| NORTH SHORE-LIJ CARECONNECT INSURANCE AG | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 471994548 | INSURANCE AGE | NY | GROUP HOLDING | C CORPORATION | false | ||||||
| CARECONNECT GROUP HOLDING COMPANY INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 472478692 | HOLDING CO | NY | HPLAN HOLDING | C CORPORATION | false | ||||||
| NORTH SHORE-LIJ PEDIATRICS OF SUFFOLK CO | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 465746956 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| NORTH SHORE-LIJ URGENT CARE PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 471758444 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| NORTH SHORE-LIJ MATERNAL FETAL MEDICINE | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 465495054 | MEDICAL SERVI | NY | NSUH | C CORPORATION | false | ||||||
| North Shore-LIJ Ophthalmology Institute | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 300930851 | inactive | NY | nsuh | c corporation | false | ||||||
| Phelps Realty Corp | |||||||||||||||
| 701 North Broadway | sleepy hollow | NY | 10591 | 133645135 | real estate | NY | phelps memorial | c corporation | false | ||||||
| Northern Westchester Oncology Management | |||||||||||||||
| 400 East Main St | Mount Kisco | NY | 10591 | 133697507 | medical svcs | NY | NORCORP | c corporation | false | ||||||
| NWHC Health Management Services Inc | |||||||||||||||
| 400 East Main St | mount kisco | NY | 10549 | 133697510 | health mgmt | NY | NORCORP | c corporation | false | ||||||
| Northern Westchester Surgical Services | |||||||||||||||
| 400 East Main St | mount kisco | NY | 10549 | 274550915 | medical svcs | NY | nwha | c corporation | false | ||||||
| North Shore-LIJ OB-GYN at New Hyde Park | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 473722278 | medical svcs | NY | nsuh | c corporation | false | ||||||
| Lakeville Surgery PC | |||||||||||||||
| 972 Brush Hollow Rd | Westbury | NY | 11590 | 474377760 | medical svcs | NY | lenox hill | c corporation | false | ||||||
| Marcus Emergency Medicine PC | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 474377679 | medical svcs | NY | lenox hill | c corporation | false | ||||||
| Carnegie Cardiovascular PC | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 474377825 | medical svcs | NY | lenox hill | c corporation | false | ||||||
| Madison Imaging PC | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 821672429 | medical svcs | NY | nsuh | c corporation | false | ||||||
| Community Drive Medicine PC | |||||||||||||||
| 972 Brush Hollow Rd | Westbury | NY | 11590 | 474447289 | medical svcs | NY | nsuh | c corporation | false | ||||||
| Weschester Health Medical PC | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 474539584 | medical svcs | NY | nsuh | c | false | ||||||
| Marcus Avenue Medical PC | |||||||||||||||
| 972 Brush Hollow Rd | Westbury | NY | 11590 | 300930577 | Medical Svcs | NY | nsuh | c corporation | false | ||||||
| CareConnect Administrative Services Inc | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 475182974 | administratio | NY | GROUP HOLDING | c corporation | false | ||||||
| Northwell FlexStaff Inc | |||||||||||||||
| 972 Brush Hollow Rd | westbury | NY | 11590 | 810836815 | inactive | NY | hci | c corporation | false | ||||||
| FEINSTEIN CENTER FOR BIOELECTRONIC MEDIC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 812885700 | INACTIVE | NY | FEINSTEIN | C | false | ||||||
| TRUE NORTH HEALTH MANAGEMENT INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813428274 | INACTIVE | NY | NW HEALTHCARE | C | false | ||||||
| PECONIC CARDIOLOGY PC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813149464 | MEDICAL SVCS | NY | NSUH | C | false | ||||||
| NARROWS IPA INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 133978565 | BUSINESS SERVICES | NY | NSUH | C | false | ||||||
| VIVOHEALTH PLANS INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 461164689 | INACTIVE | NY | NW HEALTHCARE | C | false | ||||||
| FORMATIV HEALTH MANAGEMENT INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813454243 | HOLDING CO | DE | FORM HTH INTER | C | false | ||||||
| FORMATIV HEALTH NEWCO INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813928889 | HOLDING CO | DE | FORM HTH HOLDCO | C | false | ||||||
| FORMATIV HEALTH HOLDCO INC | |||||||||||||||
| 972 BRUSH HOLLOW ROAD | WESTBURY | NY | 11590 | 813928672 | HOLDING CO | DE | FORMATIV HEALTH | C | false | ||||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | schedule r, part v | FormAndLineReferenceDesc |
| Explanation | THIS ORGANIZATION IS AN AFFILIATE OF NORTHWELL HEALTH, INC. ("NORTHWELL"). ORGANIZATIONS WITHIN NORTHWELL ROUTINELY PAY EXPENSES FOR VARIOUS AFFILIATES IN THE ORDINARY COURSE OF BUSINESS. THESE RELATED PARTY TRANSACTIONS ARE RECORDED ON THE REVENUE/EXPENSE AND BALANCE SHEET STATEMENTS OF THIS ORGANIZATION AND ITS AFFILIATES. THESE ENTITIES WORK TOGETHER TO DELIVER HIGH QUALITY HEALTHCARE AND WELLNESS SERVICES TO THE COMMUNITIES IN WHICH THEY ARE SITUATED. | ExplanationTxt |