UPSTATE MEDICAL ANESTHESIOLOGY GROUP INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- UPSTATE MEDICAL ANESTHESIOLOGY GROUP INC (EIN 16-1405520)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-14
- IRS object ID
- 201403189349306350
- Schema version
- 2013v3.0
- 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 | 2014-11-14T13:58:07-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161076996 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TESTONE MARSHALL & DISCENZA LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | THE FOUNDRY 432 NORTH FRANKLIN ST | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13204 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161405520 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UPSTATE MEDICAL ANESTHESIOLOGY GROUP INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UPST | BusinessNameControlTxt |
| Phone | 3154693447 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 EAST ADAMS STREET NO 4143 | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 132102306 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | P SEBASTIAN THOMAS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 3154693447 | PhoneNum |
| Signature | 2014-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFFREY E TRUBIA | PreparerPersonNm |
| PTIN | P00045913 | PTIN |
| Phone | 3154764004 | PhoneNum |
| Preparation | 2014-11-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | P SEBASTIAN THOMAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 EAST ADAMS STREET 4143 | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 132102306 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,571,460 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | THE CORPORATION WAS FORMED TO PROVIDE AND FACILITATE CLINICAL INSTRUCTION OF (CONT'D ON SCH. O) STUDENTS OF THE STATE UNIVERSITY OF NEW YORK UPSTATE MEDICAL UNIVERSITY, COLLEGE OF MEDICINE SYRACUSE, NEW YORK. | ActivityOrMissionDesc |
| Voting Members Governing Body | 32 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 39 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $5,556 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,137,524 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,328,024 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,635 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,954 | CYInvestmentIncomeAmt |
| PY Other Revenue | $79,397 | PYOtherRevenueAmt |
| CY Other Revenue | $239,482 | CYOtherRevenueAmt |
| PY Total Revenue | $15,223,556 | PYTotalRevenueAmt |
| CY Total Revenue | $18,571,460 | 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 | $8,772,452 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,768,768 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,284,742 | PYOtherExpensesAmt |
| CY Other Expenses | $8,196,662 | CYOtherExpensesAmt |
| PY Total Expenses | $14,057,194 | PYTotalExpensesAmt |
| CY Total Expenses | $17,965,430 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,166,362 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $606,030 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,963,046 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,569,076 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,963,046 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,569,076 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE CORPORATION WAS FORMED TO PROVIDE AND FACILITATE CLINICAL INSTRUCTION OF STUDENTS OF THE STATE UNIVERSITY OF NEW YORK UPSTATE MEDICAL UNIVERSITY, COLLEGE OF MEDICINE SYRACUSE,NEW YORK. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $17,396,620 | ExpenseAmt |
| Revenue | $18,561,950 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDED THE OPPORTUNITY FOR CLINICAL INSTRUCTION OF MEDICAL STUDENTS/RESIDENTS THROUGH TREATMENT OF PATIENTS OR SUPERVISING PATIENT CARE BY MEDICAL STUDENTS/RESIDENTS. | Desc |
| Total Program Service Expenses | $17,396,620 | 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 | Yes (1) | 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 | 0 | 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 | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 39 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 32 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | Yes (1) | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3154693447 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 750 EAST ADAMS STREET | AddressLine1 |
| City | SYRACUSE | City |
| State | NY | State |
| ZIP Code | 13210 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (39 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|
| SYED T ALI MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $249,792 | $17,676 | $87,435 | |
| JADWIGA BEDNARCZYK MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $235,449 | $17,676 | $83,813 | |
| RAHILA BILAL MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $282,515 | $17,676 | $91,237 | |
| TRACY BUCKINGHAM MD | |||||||
| VP/DIRECTOR | 30.00 | Yes (X) | Yes (X) | $125,986 | $5,198 | $65,365 | |
| J ROBERT CALIMLIM MD | |||||||
| TREASURER/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $276,941 | $87,938 | $83,781 | |
| ELIZABETH DEMERS-LAVELLE MD | |||||||
| VP/DIRECTOR | 42.00 | Yes (X) | Yes (X) | $145,549 | $80,276 | $32,346 | |
| LUCIAN DINU MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $293,989 | $22,957 | $57,135 | |
| LUNEI FITZSIMMONS MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $234,482 | $21,914 | $63,081 | |
| WENSHI GAO MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $269,905 | $68,352 | $91,492 | |
| REZA GORJI MD | |||||||
| SECRETARY/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $252,703 | $110,219 | $78,502 | |
| WENDY S HOWARD MD | |||||||
| VP/DIRECTOR | 48.00 | Yes (X) | Yes (X) | $152,543 | $26,956 | $32,818 | |
| ROBYN IGLEHART MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $125,045 | $14,786 | $30,797 | |
| SHELDON A ISAACSON MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $296,888 | $71,842 | $84,194 | |
| FENGHUA LI MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $260,457 | $82,350 | $80,109 | |
| CARLOS LOPEZ III MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $250,162 | $80,153 | $100,646 | |
| DAVID MONSOUR MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $239,045 | $17,676 | $76,986 | |
| SUSAN NOSTRAME MD | |||||||
| VP/DIRECTOR | 48.00 | Yes (X) | Yes (X) | $162,706 | $57,047 | $47,953 | |
| NANCY NUSSMEIER MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $188,039 | $205,288 | $47,819 | |
| COLLEEN O'LEARY MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $253,382 | $154,869 | $56,474 | |
| DAVID ROMANO MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $252,645 | $21,985 | $64,389 | |
| VENKATA SAMPATHI MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $181,558 | $56,351 | $61,688 | |
| MUHAMMAD SARWAR MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $273,723 | $17,676 | $86,319 | |
| BETTINA SMALLMAN MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $262,607 | $66,346 | $53,383 | |
| ANDREW SOPCHAK MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $241,057 | $111,457 | $80,266 | |
| SARAH B STUART MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $224,516 | $54,009 | $63,574 | |
| P SEBASTIAN THOMAS MD | |||||||
| PRESIDENT/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $282,591 | $201,440 | $75,568 | |
| SRINIVASA THOTA MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $194,910 | $32,476 | $60,393 | |
| KAROLINA WRZESZCZ-ONYENMA MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $229,851 | $17,676 | $77,979 | |
| ZHONG-JIN YANG MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $239,800 | $138,295 | $62,753 | |
| XIULI ZHANG MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $423,755 | $76,838 | $83,011 | |
| DONNA-ANN M THOMAS MD | |||||||
| FORMER DIRECTOR | 5.00 | Yes (X) | $20,280 | $2,081 | $5,771 | ||
| JAMES FOSTER | |||||||
| FORMER CHAIR | 30.00 | Yes (X) | $151,834 | $188,126 | $61,459 | ||
| LUCIANA CURIA MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $95,486 | $9,137 | $22,978 | |
| MATTHEW D'HAENENS MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $109,791 | $8,919 | $32,264 | |
| JEREMY MCKAY MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $107,581 | $19,675 | $23,046 | |
| VANDANA SHARMA MD | |||||||
| VP/DIRECTOR | 60.00 | Yes (X) | Yes (X) | $24,798 | $6,836 | $7,227 | |
| RICHARD BEERS | |||||||
| FORMER DIRECTOR | 0.00 | $28,457 | $21,932 | $0 | Yes (X) | ||
| CORAL D NICHOLAS | |||||||
| FORMER DIRECTOR | 0.00 | $14,743 | $0 | $0 | Yes (X) | ||
| MARIO PALMA JR | |||||||
| FORMER EXECUTIVE DIRECTOR | 0.00 | $296,365 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $7,951,926 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,212,104 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $2,214,051 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 34 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BOND SCHOENECK & KING PLLC | |||||
| 110 W FAYETTE STREET SUITE 1800 | SYRACUSE | NY | 13202 | LEGAL | $185,940 |
| EFP ROTENBERG LLP | |||||
| 280 KENNETH DRIVE SUITE 100 | ROCHESTER | NY | 14623 | ACCOUNTING | $134,104 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CLINICAL PRACTICE INCOME | 621110 | $13,546,838 | $13,546,838 |
| FEES & CONTRACTS GOV AGENCIES | 621110 | $4,758,028 | $4,758,028 |
| MISCELLANEOUS | 621110 | $23,158 | $23,158 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,328,024 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,954 | TotalRevenueColumnAmt |
| Exclusion | $3,954 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | Unrelated Business RevenueUnrelatedBusinessRevenueAmt |
|---|---|---|---|---|
| OTHER MISCELLANEOUS - INVESTMENT | 518210 | $233,926 | $233,926 | |
| OTHER MISCELLANEOUS - RENTAL | 531120 | $5,556 | $5,556 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $239,482 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,571,460 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,561,950 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $5,556 | UnrelatedBusinessRevenueAmt |
| Exclusion | $3,954 | 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 | $9,082,878 | TotalAmt |
| Program Services | $9,082,878 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,565 | TotalAmt |
| Program Services | $339,565 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $346,325 | TotalAmt |
| Program Services | $346,325 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $209,345 | TotalAmt |
| Management And General | $209,345 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,799 | TotalAmt |
| Management And General | $168,799 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,000 | TotalAmt |
| Management And General | $27,000 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,320 | TotalAmt |
| Program Services | $164,320 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,093 | TotalAmt |
| Program Services | $176,093 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,250 | TotalAmt |
| Program Services | $220,250 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,391 | TotalAmt |
| Program Services | $81,391 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,084 | TotalAmt |
| Program Services | $143,084 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BILLING & COLLECTION | $4,651,934 | $4,488,268 | $163,666 |
| TRANSFER TO RF/HSC FOUN | $1,200,000 | $1,200,000 | |
| MSG GOVERNING BOARD ASS | $604,520 | $604,520 | |
| JOURNALS/DUES/MEMEMBERS | $175,914 | $175,914 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,012 | TotalAmt |
| Program Services | $374,012 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,965,430 | TotalAmt |
| Program Services | $17,396,620 | ProgramServicesAmt |
| Management And General | $568,810 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,654,062 | BOYAmt |
| EOY | $3,132,584 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,269 | BOYAmt |
| EOY | $99,272 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,191,573 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $562,500 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $706,607 | BOYAmt |
| EOY | $629,073 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $506,108 | BOYAmt |
| EOY | $708,147 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,963,046 | BOYAmt |
| EOY | $4,569,076 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,963,046 | BOYAmt |
| EOY | $4,569,076 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,963,046 | BOYAmt |
| EOY | $4,569,076 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,963,046 | BOYAmt |
| EOY | $4,569,076 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $606,030 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| 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 | $13,290,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,432,595 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,806,753 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,207,353 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,561,950 | CurrentTaxYearAmt |
| Total | $77,298,651 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,290,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,432,595 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,806,753 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,207,353 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,561,950 | CurrentTaxYearAmt |
| Total | $77,298,651 | 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 | $77,298,651 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,307 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,593 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,068 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,635 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,954 | CurrentTaxYearAmt |
| Total | $23,557 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,307 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,593 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,068 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,635 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,954 | CurrentTaxYearAmt |
| Total | $23,557 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $9,568 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,556 | CurrentTaxYearAmt |
| Total | $15,124 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,296,307 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,436,188 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,809,821 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,223,556 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,571,460 | CurrentTaxYearAmt |
| Total | $77,337,332 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99950 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99890 | PublicSupportPY509Pct |
| Investment Income CY | 0.00030 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00100 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $90,013 | OtherCostOrOtherBasisAmt |
| Book Value | $90,013 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $554,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $218,056 | DepreciationAmt |
| Book Value | $336,931 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $170,749 | OtherCostOrOtherBasisAmt |
| Depreciation | $59,762 | DepreciationAmt |
| Book Value | $110,987 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $340,158 | OtherCostOrOtherBasisAmt |
| Depreciation | $254,779 | DepreciationAmt |
| Book Value | $85,379 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,666 | OtherCostOrOtherBasisAmt |
| Depreciation | $29,903 | DepreciationAmt |
| Book Value | $5,763 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $629,073 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT-MEDICAL CENTER WEST, LLC | -$199,498 |
| INVESTMENT-WEST GENESEE LAND COMPANY, INC | $30,022 |
| INVESTMENT IN SUBSIDIARY-CNY MEDICAL BILLING | $877,623 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $708,147 | TotalBookValueOtherAssetsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (34 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SYED T ALI MD | ||||||||||||||
| VP/DIRECTOR | $232,531 | $17,676 | $17,261 | $0 | $0 | $0 | $50,513 | $0 | $13,638 | $23,284 | $313,943 | $40,960 | $0 | $0 |
| JADWIGA BEDNARCZYK MD | ||||||||||||||
| VP/DIRECTOR | $219,061 | $17,676 | $16,388 | $0 | $0 | $0 | $47,090 | $0 | $13,439 | $23,284 | $295,978 | $40,960 | $0 | $0 |
| RAHILA BILAL MD | ||||||||||||||
| VP/DIRECTOR | $273,925 | $17,676 | $8,590 | $0 | $0 | $0 | $54,048 | $0 | $13,905 | $23,284 | $350,468 | $40,960 | $0 | $0 |
| TRACY BUCKINGHAM MD | ||||||||||||||
| VP/DIRECTOR | $115,811 | $5,198 | $10,175 | $0 | $0 | $0 | $34,202 | $0 | $6,878 | $24,285 | $167,066 | $29,483 | $0 | $0 |
| J ROBERT CALIMLIM MD | ||||||||||||||
| TREASURER/DIRECTOR | $233,307 | $87,938 | $43,634 | $0 | $0 | $0 | $51,346 | $0 | $8,881 | $23,554 | $337,168 | $111,492 | $0 | $0 |
| ELIZABETH DEMERS-LAVELLE MD | ||||||||||||||
| VP/DIRECTOR | $126,457 | $80,276 | $19,092 | $0 | $0 | $0 | $29,110 | $0 | $3,236 | $0 | $177,895 | $80,276 | $0 | $0 |
| LUCIAN DINU MD | ||||||||||||||
| VP/DIRECTOR | $239,485 | $22,957 | $54,504 | $0 | $0 | $0 | $51,000 | $0 | $6,135 | $0 | $351,124 | $22,957 | $0 | $0 |
| LUNEI FITZSIMMONS MD | ||||||||||||||
| VP/DIRECTOR | $198,883 | $21,914 | $35,599 | $0 | $0 | $0 | $46,896 | $0 | $8,321 | $7,864 | $289,699 | $29,778 | $0 | $0 |
| WENSHI GAO MD | ||||||||||||||
| VP/DIRECTOR | $228,006 | $45,352 | $41,899 | $0 | $0 | $23,000 | $59,900 | $0 | $11,654 | $19,938 | $341,459 | $88,290 | $0 | $0 |
| REZA GORJI MD | ||||||||||||||
| SECRETARY/DIRECTOR | $224,693 | $91,852 | $28,010 | $0 | $0 | $18,367 | $50,541 | $0 | $9,267 | $18,694 | $312,511 | $128,913 | $0 | $0 |
| WENDY S HOWARD MD | ||||||||||||||
| VP/DIRECTOR | $140,188 | $26,956 | $12,355 | $0 | $0 | $0 | $30,509 | $0 | $2,309 | $0 | $185,361 | $26,956 | $0 | $0 |
| ROBYN IGLEHART MD | ||||||||||||||
| VP/DIRECTOR | $122,944 | $14,786 | $2,101 | $0 | $0 | $0 | $25,009 | $0 | $5,788 | $0 | $155,842 | $14,786 | $0 | $0 |
| SHELDON A ISAACSON MD | ||||||||||||||
| VP/DIRECTOR | $287,267 | $52,808 | $9,621 | $0 | $0 | $19,034 | $57,578 | $0 | $6,865 | $19,751 | $361,331 | $91,593 | $0 | $0 |
| FENGHUA LI MD | ||||||||||||||
| VP/DIRECTOR | $211,034 | $67,468 | $49,423 | $0 | $0 | $14,882 | $51,000 | $0 | $8,994 | $20,115 | $320,451 | $102,465 | $0 | $0 |
| CARLOS LOPEZ III MD | ||||||||||||||
| VP/DIRECTOR | $234,689 | $80,153 | $15,473 | $0 | $0 | $0 | $60,720 | $0 | $16,372 | $23,554 | $327,254 | $103,707 | $0 | $0 |
| DAVID MONSOUR MD | ||||||||||||||
| VP/DIRECTOR | $216,920 | $17,676 | $22,125 | $0 | $0 | $0 | $48,214 | $0 | $5,488 | $23,284 | $292,747 | $40,960 | $0 | $0 |
| SUSAN NOSTRAME MD | ||||||||||||||
| VP/DIRECTOR | $145,765 | $57,047 | $16,941 | $0 | $0 | $0 | $32,541 | $0 | $6,021 | $9,391 | $201,268 | $66,438 | $0 | $0 |
| NANCY NUSSMEIER MD | ||||||||||||||
| VP/DIRECTOR | $187,320 | $205,288 | $719 | $0 | $0 | $0 | $39,177 | $0 | $8,642 | $0 | $235,858 | $205,288 | $0 | $0 |
| COLLEEN O'LEARY MD | ||||||||||||||
| VP/DIRECTOR | $228,667 | $131,869 | $24,715 | $0 | $0 | $23,000 | $50,676 | $0 | $5,798 | $0 | $309,856 | $154,869 | $0 | $0 |
| DAVID ROMANO MD | ||||||||||||||
| VP/DIRECTOR | $219,852 | $21,985 | $32,793 | $0 | $0 | $0 | $50,690 | $0 | $5,907 | $7,792 | $309,242 | $29,777 | $0 | $0 |
| VENKATA SAMPATHI MD | ||||||||||||||
| VP/DIRECTOR | $169,093 | $56,351 | $12,465 | $0 | $0 | $0 | $36,664 | $0 | $1,740 | $23,284 | $219,962 | $79,635 | $0 | $0 |
| MUHAMMAD SARWAR MD | ||||||||||||||
| VP/DIRECTOR | $251,340 | $17,676 | $22,383 | $0 | $0 | $0 | $51,733 | $0 | $11,302 | $23,284 | $336,758 | $40,960 | $0 | $0 |
| BETTINA SMALLMAN MD | ||||||||||||||
| VP/DIRECTOR | $221,932 | $66,346 | $40,675 | $0 | $0 | $0 | $51,000 | $0 | $2,383 | $0 | $315,990 | $66,346 | $0 | $0 |
| ANDREW SOPCHAK MD | ||||||||||||||
| VP/DIRECTOR | $192,646 | $93,957 | $48,411 | $0 | $0 | $17,500 | $49,011 | $0 | $7,701 | $23,554 | $297,769 | $135,011 | $0 | $0 |
| SARAH B STUART MD | ||||||||||||||
| VP/DIRECTOR | $198,162 | $43,383 | $26,354 | $0 | $0 | $10,626 | $45,054 | $0 | $9,464 | $9,056 | $279,034 | $63,065 | $0 | $0 |
| P SEBASTIAN THOMAS MD | ||||||||||||||
| PRESIDENT/DIRECTOR | $248,419 | $178,440 | $34,172 | $0 | $0 | $23,000 | $51,000 | $0 | $6,113 | $18,455 | $339,704 | $219,895 | $0 | $0 |
| SRINIVASA THOTA MD | ||||||||||||||
| VP/DIRECTOR | $183,561 | $32,476 | $11,349 | $0 | $0 | $0 | $40,259 | $0 | $6,525 | $13,609 | $241,694 | $46,085 | $0 | $0 |
| KAROLINA WRZESZCZ-ONYENMA MD | ||||||||||||||
| VP/DIRECTOR | $213,130 | $17,676 | $16,721 | $0 | $0 | $0 | $49,302 | $0 | $5,393 | $23,284 | $284,546 | $40,960 | $0 | $0 |
| ZHONG-JIN YANG MD | ||||||||||||||
| VP/DIRECTOR | $184,857 | $115,980 | $54,943 | $0 | $0 | $22,315 | $47,960 | $0 | $7,144 | $7,649 | $294,904 | $145,944 | $0 | $0 |
| XIULI ZHANG MD | ||||||||||||||
| VP/DIRECTOR | $304,862 | $53,838 | $118,893 | $0 | $0 | $23,000 | $51,000 | $0 | $12,657 | $19,354 | $487,412 | $96,192 | $0 | $0 |
| JAMES FOSTER | ||||||||||||||
| FORMER CHAIR | $151,638 | $165,126 | $196 | $0 | $0 | $23,000 | $30,767 | $0 | $7,138 | $23,554 | $189,739 | $211,680 | $0 | $0 |
| MATTHEW D'HAENENS MD | ||||||||||||||
| VP/DIRECTOR | $94,458 | $8,919 | $15,333 | $0 | $0 | $0 | $21,958 | $0 | $1,006 | $9,300 | $132,755 | $18,219 | $0 | $0 |
| JEREMY MCKAY MD | ||||||||||||||
| VP/DIRECTOR | $86,657 | $19,675 | $20,924 | $0 | $0 | $0 | $21,516 | $0 | $1,530 | $0 | $130,627 | $19,675 | $0 | $0 |
| MARIO PALMA JR | ||||||||||||||
| FORMER EXECUTIVE DIRECTOR | $296,365 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $296,365 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE COMPENSATION RECEIVED BY THE ORGANIZATION'S DIRECTORS IS DETERMINED BY A CLINICAL PLAN THAT PROVIDES FOR THE MAXIMUM ALLOWABLE COMPENSATION AS DETERMINED BY THE ACADEMIC RANK OF THE MEMBER AND ANY SALARY SUPPLEMENT WILL BE DETERMINED BY THE CHAIR OF THE DEPARTMENT ON BEHALF OF THE MEMBER WITH THE AGREEMENT OF THE DEAN OF COLLEGE OF MEDICINE. |
| PART I, LINE 4A | MARIO PALMA $296,365 |
| PART I, LINE 7 | EMPLOYEES ARE REIMBURSED FOR BUSINESS EXPENSES THAT RELATE TO THE PRACTICE OF MEDICINE. AMOUNT FOR EACH EMPLOYEE IS PREDETERMINED AND NOT TO BE EXCEEDED IN A GIVEN YEAR. ALL REIMBURSEMENTS ARE SUBJECT TO APPROVAL BY THE PRESIDENT OR THEIR DESIGNEE FOR AN EXPENSE TO BE ELIGIBLE FOR REIMBURSEMENT. DOCUMENTATION MUST BE SUBMITTED TO CORROBORATE THE EXPENDITURES AND ORIGINAL SUPPORT DOCUMENTATION IS TO BE SUPPLIED. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE PRESIDENT OF THE ORGANIZATION WILL REVIEW THE 990 AND DRAFT COPIES OF THE 990 WILL BE PROVDIED TO THE ENTIRE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY FORM IS COMPLETED ANNUALLY AND SUBMITTED TO THE INSTITUTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | ANNUAL COMPENSATION IS DETERMINED IN ACCORDANCE WITH THE ORGANIZATION'S CLINICAL PRACTICE PLAN AND IN CONSULTATION WITH THE DEAN OF THE COLLEGE OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK, SYRACUSE NEW YORK. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 24E | MATERIALS AND SUPPLIES: PROGRAM SERVICE EXPENSES 162,150. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 162,150. EDUCATION SUPPLIES AND EXPENSES: PROGRAM SERVICE EXPENSES 131,748. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 131,748. CHARITABLE DONATIONS: PROGRAM SERVICE EXPENSES 42,316. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,316. OTHER OPERATING EXPENSES: PROGRAM SERVICE EXPENSES 37,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,798. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK | |||||||||
| PO BOX 9 | ALBANY | NY | 122010009 | 141368361 | RESEARCH | NY | 501(C)(3) | LINE 7 | 0 |
| STATE OF NEW YORK DEPARTMENT OF STATE | |||||||||
| ONE COMMERCE PLAZA 99 WASHINGTON AV | ALBANY | NY | 122310001 | 146013200 | GOVERNMENT | NY | 501(C)(1) | 0 | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Predominant Income TypePredominantIncomeTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Disproportionate AllocationsDisproportionateAllocationsInd | General Or Managing PartnerGeneralOrManagingPartnerInd | OwnershipOwnershipPct |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WEST GENESEE LAND COMPANY LLC | ||||||||||||
| C/O SUTTON REAL ESTATE 525 PLUM ST | SYRACUSE | NY | 13204 | 161610090 | REAL ESTATE RENTAL | NY | UNRELATED | -$710 | $30,022 | 0 | 0 | 0.10130 |
| MEDICAL CETNER WEST LLC | ||||||||||||
| C/O SUTTON REAL ESTATE 525 PLUM ST | SYRACUSE | NY | 13204 | 161497697 | REAL ESTATE RENTAL | NY | UNRELATED | $6,323 | 0 | 0 | 0.10130 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1 | CityUSAddress/City | StateUSAddress/State | ZIP CodeUSAddress/ZIPCode | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1 | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CNY MEDICAL BILLING ASSOCIATES | ||||||||||||
| 163 INTREPID LANE | SYRACUSE | NY | 13205 | 161405690 | MEDICAL BILLING | NY | UPSTATE MEDICAL ANESTHESIOLOGY GROUP INC | C | $3,125,624 | $1,135,252 | 1.00000 | Yes (1) |
| ANESTHESIA CONSULTANT OF CNY | ||||||||||||
| 163 INTREPID LANE | SYRACUSE | NY | 13205 | 161607984 | MEDICAL SERVICES | NY | UPSTATE MEDICAL ANESTHESIOLOGY GROUP INC | C | 1.00000 | Yes (1) | ||
| 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 | 0 | 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 | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | 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 |
Transactions Related Org TransactionsRelatedOrgGrp (6 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CNY MEDICAL BILLING ASSOCIATES INC | ||
| M | $3,125,624 | FMV |
| THE RESEARCH FOUNDATION FOR THE STATE UNIVERSITY OF NEW YORK | ||
| P | $1,200,000 | FMV |
| STATE OF NEW YORK DEPARTMENT OF STATE | ||
| L | $1,001,054 | FMV |
| STATE OF NEW YORK DEPARTMENT OF STATE | ||
| O | $104,177 | FMV |
| STATE OF NEW YORK DEPARTMENT OF STATE | ||
| P | $1,844,723 | FMV |
| STATE OF NEW YORK DEPARTMENT OF STATE | ||
| Q | $6,602,751 | FMV |