STRATEGY STUDIO / PUBLIC DATA EXPLORER

STONY BROOK UROLOGY UNIVERSITY FACULTY PRACTICE CORPORATION: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
STONY BROOK UROLOGY UNIVERSITY FACULTY PRACTICE CORPORATION (EIN 11-2644371)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-14
IRS object ID
201431349349302023
Schema version
2012v2.3
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Timestamp2014-05-14T09:03:08-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1111 MONUMENT CIRCLE SUITE 4000AddressLine1
CityINDIANAPOLISCity
StateINState
ZIP Code46204ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN112644371EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STONY BROOK UROLOGYBusinessNameLine1
Business Name Line2University Faculty Practice CorporationBusinessNameLine2
FieldValueIRS element (for citing)
In Care Of Name% CLINICAL PRACTICE MGMT PLANInCareOfName
Name ControlSTONNameControl
Phone6314442055Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
Address Line2SuiteAddressLine2
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameWAYNE WALTZERName
TitlePRESIDENTTitle
Date Signed2014-05-08DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
Phone3176817000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonWayne Waltzer MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode
FieldValueIRS element (for citing)
Gross Receipts7148970GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1983YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionProvide clinical instruction to and supervision of medical school students, interns and residents and, incident thereto, rendering professional services.ActivityOrMissionDescription
Nbr Voting Members Governing Body3NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees12TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7531216ProgramServiceRevenuePriorYear
Program Service Revenue CY7146335ProgramServiceRevenueCY
Investment Income Prior Year5530InvestmentIncomePriorYear
Investment Income Current Year2635InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year7536746TotalRevenuePriorYear
Total Revenue Current Year7148970TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2625503SalariesEtcPriorYear
Salaries Etc Current Year3186286SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4744781OtherExpensePriorYear
Other Expenses Current Year4250185OtherExpensesCurrentYear
Total Expenses Prior Year7370284TotalExpensesPriorYear
Total Expenses Current Year7436471TotalExpensesCurrentYear
Revenues Less Expenses Prior Year166462RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-287501RevenuesLessExpensesCY
Total Assets BOY1010691TotalAssetsBOY
Total Assets EOY723191TotalAssetsEOY
Total Liabilities BOY1010691TotalLiabilitiesBOY
Total Liabilities EOY723191TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE CLINICAL INSTRUCTION TO AND SUPERVISION OF MEDICAL SCHOOL STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL SERVICES.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense6595782Expense
Revenue7146335Revenue
DescriptionThe organization provides services in the field of Urology to patients and provides clinical instruction to and supervision of School of Medicine students and Hospital residents.Description
Total Program Service Expense6595782TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquipfalseReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntitytrueRelatedOrgControlledEntity
Transaction Related EntitytrueTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10961NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees12NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members3NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonCLINICAL PRACTICE MGMT PLANNamePerson
Telephone Number6314442055TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 1554AddressLine1
CityStony BrookCity
StateNYState
ZIP Code11790ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (8 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
Wayne Waltzer
President & Director50.00.0XX54467823053480124
Robert Wasnick
Secretary & Director50.00.0XX17753812897749749
Sadar Ali Khan
Director50.00.0X5703215349639716
Frank Darras
Urologist50.00.036532220035064681X
Rahuldev Bhalla
Urologist50.00.02470008043137338X
David Schulsinger
Urologist50.00.03048177525354661X
Yefim Sheynkin
Urologist50.00.02941865673350074X
Zelick Frischer
Urologist50.00.04723720425749805X
FieldValueIRS element (for citing)
Total Reportable Comp From Org2037810TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1130031TotalReportableCompFrmRltdOrgs
Total Other Compensation426148TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT SERVICE REVENUEDescription
Business Code621111BusinessCode
Total Revenue Column7146335TotalRevenueColumn
Related Or Exempt Function Income7146335RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue7146335TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2635TotalRevenueColumn
Exclusion$2,635ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column7148970TotalRevenueColumn
Related Or Exempt Function Income7146335RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,635ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total853773Total
Program Services811084ProgramServices
Management And General42689ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2056105Total
Program Services2056105ProgramServices

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total144732Total
Program Services144732ProgramServices

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total10970Total
Program Services10970ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total120706Total
Program Services120706ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total4200000Total
Program Services3402000ProgramServices
Management And General798000ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total37788Total
Program Services37788ProgramServices

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total8825Total
Program Services8825ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total0Total

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total0Total

Insurance Insurance

FieldValueIRS element (for citing)
Total3533Total
Program Services3533ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
CORPORATION TAX2525
OTHER EXPENSES1414

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total7436471Total
Program Services6595782ProgramServices
Management And General840689ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1010691BOY
EOY723191EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY0BOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1010691BOY
EOY723191EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1010691BOY
EOY723191EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Tax Exempt Bond Liabilities TaxExemptBondLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Escrow Account Liability EscrowAccountLiability

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Loans From Officers Directors LoansFromOfficersDirectors

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Unsecured Notes Loans Payable UnsecuredNotesLoansPayable

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1010691BOY
EOY723191EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1010691BOY
EOY723191EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-287501ReconcilationRevenueExpenses
Reconcilation Other Changes287501ReconcilationOtherChanges
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years0CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years0CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years0CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year0CurrentTaxYearMinus1Year
Current Tax Year0CurrentTaxYear
Total0Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5347090CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5965218CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6437558CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7531216CurrentTaxYearMinus1Year
Current Tax Year7146339CurrentTaxYear
Total32427421Total

Gross Receipts From Non UBI GrossReceiptsFromNonUBI

FieldValueIRS element (for citing)
Total0Total

Tax Rev Levied For Org Benefit509 TaxRevLeviedForOrgBenefit509

FieldValueIRS element (for citing)
Total0Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Total0Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5347090CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5965218CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6437558CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7531216CurrentTaxYearMinus1Year
Current Tax Year7146339CurrentTaxYear
Total32427421Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years424976CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years515517CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years483770CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year983006CurrentTaxYearMinus1Year
Current Tax Year1003777CurrentTaxYear
Total3411046Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years424976CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years515517CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years483770CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year983006CurrentTaxYearMinus1Year
Current Tax Year1003777CurrentTaxYear
Total3411046Total
FieldValueIRS element (for citing)
Public Support Total50929016375PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4625CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21073CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1617CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5530CurrentTaxYearMinus1Year
Current Tax Year2638CurrentTaxYear
Total35483Total

Post1975 UBTI Post1975UBTI

FieldValueIRS element (for citing)
Total0Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4625CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years21073CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1617CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5530CurrentTaxYearMinus1Year
Current Tax Year2638CurrentTaxYear
Total35483Total

Net Income From Other UBI NetIncomeFromOtherUBI

FieldValueIRS element (for citing)
Total0Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Total0Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5351715CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5986291CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6439175CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7536746CurrentTaxYearMinus1Year
Current Tax Year7148977CurrentTaxYear
Total32462904Total
FieldValueIRS element (for citing)
Public Support Percentage5090.89383PublicSupportPercentage509
Prior Year Support Percentage0.90280PriorYearSupportPercentage
Investment Income Percentage0.00109InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00130PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentstrueAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Wayne Waltzer
President & Director39092423053415030403450000382704185458294827238800
Robert Wasnick
Secretary & Director1487331289772563203173000231292662020066715559700
Sadar Ali Khan
Director546271534960024050009418302986645018379400
Frank Darras
Urologist2628032003509906903450000394932518840481522553800
Rahuldev Bhalla
Urologist19959980431456760172500023135142032701359463400
David Schulsinger
Urologist171797752531300760294400037109175523419269280500
Yefim Sheynkin
Urologist20271056733884530302300034930151443291167187700
Zelick Frischer
Urologist509520425741927021500011893379125913024216900

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierSupplemental Compensation InformationIdentifier
Return ReferenceSCHEDULE J, PART I, LINE 7ReturnReference
ExplanationEMPLOYEES ARE REIMBURSED FOR BUSINESS EXPENSES THAT RELATE TO THE PRACTICE OF MEDICINE. THE TOTAL AMOUNT REIMBURSABLE IN A GIVEN FISCAL YEAR IS DETERMINED BY THE RESPECTIVE CHAIRPERSON. ALL REIMBURSEMENTS ARE SUBJECT TO APPROVAL BY THE CHAIRPERSON OR THEIR DESIGNEE. FOR AN EXPENSE TO BE ELIGIBLE FOR REIMBURSEMENT, IT MUST BE ALLOWABLE "IN ACCORDANCE WITH GENERALLY ACCEPTED ACCOUNTING PRINCIPLES AND ALLOWABLE TO A PRACTITIONER AS A DEDUCTIBLE COST OR EXPENSE UNDER CURRENT FEDERAL INTERNAL REVENUE SERVICE GUIDELINES." DOCUMENTATION OF EXPENSES FOLLOWS IRS GUIDELINES. EXPENSES ARE NOT PROCESSED UNLESS THEY HAVE COMPLETE DOCUMENTATION. EXPENDITURES THAT ARE $25,000 OR GREATER, UNPRECEDENTED, OR UNUSUAL, WILL REQUIRE PRIOR APPROVAL FROM THE PURCHASING AND ASSET MANAGEMENT COMMITTEE.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Describe the Process used by Management &/or Governing Body to Review 990Form 990, Part VI, Question 11BAN ELECTRONIC VERSION OF FORM 990 WAS PROVIDED TO THE OFFICERS AND DIRECTORS PRIOR TO FILING. MANAGEMENT PERFOMS A REVIEW of FORM 990 PRIOR TO FILING, ADDRESSING ANY QUESTIONS MADE BY THE GOVERNING BODY.
Description of Process to Monitor Transactions for Conflicts of InterestForm 990, Part VI, Question 12cTHE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT THE UFPC'S INTEREST WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTEREST OF AN OFFICER OR DIRECTOR OF THE UFPC OR MIGHT RESULT IN A POSSIBLE EXCESS BENEFIT TRANSACTION. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OF COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. COMPLIANCE WITH THIS POLICY IS MONITORED THROUGH INTERNAL PAYMENT POLICIES AND ANNUAL REPRESENTATIONS. THE REVIEWS, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: A. WHETHER COMPENSATION ARRANGEMENTS AND BENEFITS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND THE RESULT OF ARM'S LENGTH BARGAINING. B. WHETHER PARTNERSHIPS, JOINT VENTURES, AND ARRANGEMENTS WITH MANAGEMENT ORGANIZATIONS CONFORM TO THE UFPC'S WRITTEN POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE INVESTMENT OR PAYMENT FOR GOODS AND SERVICES, FURTHER EDUCATIONAL PURPOSES AND DO NOT RESULT IN INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT OR IN AN EXCESS BENEFIT TRANSACTION. A VOTING MEMBER OF THE GOVERNING BOARD WHO HAS A COMPENSATION CONFLICT IS PRECLUDED FROM VOTING ON MATTERS PERTAINING TO THAT MEMBER'S COMPENSATION. IF THERE ARE VIOLATIONS TO THE POLICY, THE COMMITTEE OR GOVERNING BOARD SHALL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION.
Offices & Positions for Which Process was Used, & Year Process was BegunForm 990, Part VI, Questions 15a & 15bBEGAN AT INCEPTION: EACH PHYSICIAN IS A MEMBER OF THE SCHOOL OF MEDICINE'S FACULTY AND A NEW YORK STATE EMPLOYEE PROVIDING SERVICES AT THE UNIVERSITY, AND REPORTS TO THE CHAIRMAN OF HIS/HER DEPARTMENT AND THE DEAN OF THE SCHOOL OF MEDICINE, WHO IN TURN REPORTS TO THE PRESIDENT OF THE UNIVERSITY. THE DEAN OF THE SCHOOL OF MEDICINE IS RESPONSIBLE FOR HIRING AND TERMINATING EACH PHYSICIAN, DETERMINING EACH PHYSICIAN'S COMPENSATION (WHICH IS SUBJECT TO THE LIMITATIONS IN ARTICLE XVI AS DESCRIBED BELOW), AND ALSO APPOINTS THE CHAIRPERSON OF THE SCHOOL OF MEDICINE'S DEPARTMENT OF UROLOGY, (I) WHO IS ONE OF THE DIRECTORS; AND (II) WHO IN TURN SELECTS ITS OTHER TWO DIRECTORS. CONSEQUENTLY, THE DIRECTORS MUST ACT IN A MANNER WHICH WILL NOT JEOPARDIZE THEIR EMPLOYMENT WITH THE MEDICAL SCHOOL AND THE UNIVERSITY IN ORDER TO REMAIN ON THE BOARD. AS A RESULT, NEW YORK STATE, THROUGH THE SUNY SYSTEM, THE UNIVERSITY, THE MEDICAL SCHOOL, AND CPMP (AS EXPLAINED BELOW) EXERCISES SUBSTANTIAL CONTROL OVER OPERATIONS, WHICH ARE ALSO SUBJECT TO ORIGINATING DOCUMENTS (I.E., CERTIFICATE OF REINCORPORATION AND BYLAWS), WHICH STATE THE PURPOSE AS FURTHERING THE UNIVERSITY'S EDUCATIONAL MISSION. ALL PHYSICIANS ENTER INTO EMPLOYMENT ARRANGEMENTS WITH THE UFPC. AS A RESULT, EACH PHYSICIAN RECEIVES COMPENSATION AND BENEFITS FROM THE UFPC AND THE STATE OF NEW YORK (BECAUSE SUCH PHYSICIAN IS ALSO A UNIVERSITY EMPLOYEE). THE DEAN OF THE SCHOOL OF MEDICINE DETERMINES EACH PHYSICIAN'S COMPENSATION, IN CONSULTATION WITH SUCH PHYSICIAN'S DEPARTMENTAL CHAIRPERSON. DOCUMENTATION REGARDING SUCH COMPENSATION DETERMINATION IS MAINTAINED BY THE DEAN'S OFFICE. EACH PHYSICIAN IS COMPENSATED BASED ON TRADITIONAL FACTORS SUCH AS TRAINING, EXPERIENCE, QUALIFICATIONS, AND GENERAL MARKET CONDITIONS. SUBJECT TO THE LIMITATIONS DESCRIBED BELOW, EMPLOYMENT AGREEMENTS WITH PHYSICIANS TYPICALLY ALLOW AN INDIVIDUAL PHYSICIAN TO RECEIVE NON-FIXED COMPENSATION, BASED ON AMOUNTS COLLECTED WHICH ARE ATTRIBUTABLE TO SUCH PHYSICIAN'S DIRECT PATIENT CARE SERVICES. THE ORGANIZATION GENERALLY DETERMINES A PHYSICIAN'S COMPENSATION TO EQUAL AN AMOUNT BETWEEN THE 50TH AND 75TH PERCENTILE OF COMPARABLE PHYSICIAN COMPENSATION, AS REPORTED IN THE ASSOCIATION OF AMERICAN MEDICAL COLLEGE'S (THE "AAMC'S") COMPENSATION DATA REFERENCE MATERIALS. EACH PHYSICIAN IS ALSO SUBJECT TO ARTICLE XVI, WHICH AT ALL TIMES GOVERNS SUCH PHYSICIAN'S COMPENSATION. UNDER THE TERMS OF ARTICLE XVI, THE MAXIMUM AMOUNT OF COMPENSATION PAYABLE TO ANY PHYSICIAN (INCLUDING COMPENSATION FROM ALL OTHER SOURCE EXCLUSIVE OF FRINGE BENEFITS) IS NOT TO EXCEED 250% OF THAT INDIVIDUAL'S MAXIMUM STATE BASIC ANNUAL SALARY FOR HIS/HER ACADEMIC RANK (THE "250% RULE"). IN SPECIAL CIRCUMSTANCES RELATING TO RECRUITMENT, THE UNIVERSITY PRESIDENT (OR HIS/HER DESIGNEE) MAY AUTHORIZE AN PHYSICIAN TO RECEIVE GREATER THAN 250% OF THE MAXIMUM STATE BASIC ANNUAL SALARY FOR SUCH PHYSICIAN'S RANK, PROVIDED THAT SUCH COMPENSATION IS IN THE BEST INTEREST OF THE UNIVERSITY AND THE HOSPITAL. SUCH ADDITIONAL COMPENSATION SHALL NOT EXTEND BEYOND A TWO YEAR PERIOD. ALSO, WITH THE APPROVAL OF THE CHANCELLOR OF THE SUNY SYSTEM (OR HIS/HER DESIGNEE) THE MAXIMUM ALLOWABLE COMPENSATION PAYABLE TO A PHYSICIAN MAY EXCEED 275% OF SUCH INDIVIDUAL'S MAXIMUM STATE BASIC ANNUAL SALARY (E.G., IN THE CASE OF PHYSICIANS PROVIDING SERVICES IN DIFFICULT TO RETAIN SPECIALTIES). IN MAKING RECOMMENDATIONS WITH RESPECT TO SUCH EXCEPTIONS TO THE "250% RULE", THE PRESIDENT OF THE UNIVERSITY CONSIDERS THE COMPETITION FOR PHYSICIANS IN A PARTICULAR SPECIALTY AS INDICATED BY THE AAMC'S COMPENSATION DATA, AND OTHER REVENUE GENERATED BY THE PHYSICIAN'S CLINICAL ACTIVITIES. SUCH EXCEPTIONS, PURSUANT TO THE TERMS OF ARTICLE XVI, SHALL NOT EXCEED 5% OF THE TOTAL NUMBER OF PHYSICIANS ON A SYSTEM-WIDE BASIS. ALSO, SUBJECT TO THE TERMS OF ARTICLE XVI, A PORTION OF EACH PHYSICIAN'S COMPENSATION MAY BE USED TO PURCHASE A RETIREMENT BENEFIT FOR THE BENEFIT OF PHYSICIANS.
Avail of Gov Docs, Conflict of Interest Policy, & Fin Stmts to Gen PublicForm 990, Part VI, Question 19ALL GOVERNING DOCUMENTS WILL NOT BE DISCLOSED OUTSIDE OF THE ORGANIZATION. THE CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ALSO WILL NOT BE DISCLOSED OUTSIDE OF THE ORGANIZATION.
HOURS DEVOTED TO RELATED ORGANIZATIONFORM 990, PART VIITHE MISSION OF THE REPORTING ORGANIZATION IS TO SUPPORT THE EDUCATIONAL MISSION OF THE STATE UNIVERSITY OF NEW YORK SCHOOL OF MEDICINE AT STONY BROOK (THE "MEDICAL SCHOOL") BY PROVIDING CLINICAL INSTRUCTION TO AND SUPERVISION OF MEDICAL SCHOOL STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL SERVICES. EACH PHYSICIAN IS AN EMPLOYEE OF THE REPORTING ORGANIZATION AND A NEW YORK STATE EMPLOYEE PROVIDING SERVICES AS A MEMBER OF THE THE MEDICAL SCHOOL'S FACULTY. HOURS WORKED BY THE PHYSICIANS LISTED IN PART VII RELATE TO THE ENTIRE MISSION OF THE REPORTING ORGANIZATION WHICH INCLUDES SUPPORTING THE MISSION OF THE MEDICAL SCHOOL.
OTHER CHANGES IN NET ASSETSFORM 990, PART XI, LINE 9Cash transfer from Clinical Practice Management Plan = $287,498

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (22 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
New York State
1 Commerce Plz 99 Washington AveAlbanyNY12231146013200GovernmentNY501(c)(1)N/ANAfalse
Stony Brook Anaesthesiology UFPC
PO Box 1554Stony BrookNY11790112553515HealthcareNY501(c)(3)9NYStrue
Stony Brook Dermatology Associates UFPC
PO Box 1554Stony BrookNY11790113011790HealthcareNY501(c)(3)9NYStrue
Stony Brook Clin Pract Mgmt Realty Corp
PO Box 1554Stony BrookNY11790113285712Rlty HoldingNY501(c)(25)N/ANYStrue
Stony Brook Surgical Holding Corp
PO Box 1554Stony BrookNY11790116434538Rlty HoldingNY501(c)(25)N/ANYStrue
Stony Brook University Physicians UFPC
PO Box 1554Stony BrookNY11790113559055Support SvcsNY501(c)(3)9NYStrue
CLINICAL PRACTICE MANAGEMENT PLAN
PO Box 1554Stony BrookNY11790112664726Mgmt ActivityNY501(c)(1)N/ANAfalse
Stony Brook Emergency Physicians UFPC
PO Box 1554Stony BrookNY11790113066770HealthcareNY501(c)(3)9NYStrue
Stony Brook Family Medical Group UFPC
PO Box 1554Stony BrookNY11790112552321HealthcareNY501(c)(3)9NYStrue
Stony Brook Internists UFPC
PO Box 1554Stony BrookNY11790112558775HealthcareNY501(c)(3)9NYStrue
New York Spine and Brain Surgery UFPC
PO Box 1554Stony BrookNY11790112645930HealthcareNY501(c)(3)9NYStrue
Stony Brook Preventive Med Srvc UFPC
PO Box 1554Stony BrookNY11790112822992HealthcareNY501(c)(3)9NYStrue
Neurology Assoc of Stony Brook UFPC
PO Box 1554Stony BrookNY11790112587430HealthcareNY501(c)(3)9NYStrue
Univ Assoc in Obst & Gynecology UFPC
PO Box 1554Stony BrookNY11790112569522HealthcareNY501(c)(3)9NYStrue
Stony Brook Pathologists UFPC
PO Box 1554Stony BrookNY11790112647243HealthcareNY501(c)(3)9NYStrue
Stony Brook Ophthalmology UFPC
PO Box 1554Stony BrookNY11790112658697HealthcareNY501(c)(3)9NYStrue
Stony Brook Orthopaedic Associates UFPC
PO Box 1554Stony BrookNY11790112593061HealthcareNY501(c)(3)9NYStrue
Stony Brook Children's Service UFPC
PO Box 1554Stony BrookNY11790112571524HealthcareNY501(c)(3)9NYStrue
Stony Brook Psychiatric Associates UFPC
PO Box 1554Stony BrookNY11790112590096HealthcareNY501(c)(3)9NYStrue
Stony Brook Radiation Oncology UFPC
PO Box 1554Stony BrookNY11790112664726HealthcareNY501(c)(3)9NYStrue
Stony Brook Radiology UFPC
PO Box 1554Stony BrookNY11790112548304HealthcareNY501(c)(3)9NYStrue
Stony Brook Surgical Associates UFPC
PO Box 1554Stony BrookNY11790112552333HealthcareNY501(c)(3)9NYStrue

Form990 Schedule R Part III Form990ScheduleRPartIII

Name Of Related Org NameOfRelatedOrg

FieldValueIRS element (for citing)
Business Name Line1SB HLTHCARE IPA LLCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 1554AddressLine1
CitySTNY BRKCity
StateNYState
ZIP Code11790ZIPCode
FieldValueIRS element (for citing)
EIN113499101EIN
Primary ActivityHealthcarePrimaryActivity
Legal Domicile StateNYLegalDomicileState

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1CPMPBusinessNameLine1
FieldValueIRS element (for citing)
Disproportionate AllocationsfalseDisproportionateAllocations
General Or Managing PartnerfalseGeneralOrManagingPartner

Form990 Schedule R Part IV Form990ScheduleRPartIV (3 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrg
Suffolk Psychiatric Services PC
PO Box 1554Stony BrookNY11790113115689managed hlth svcsNYCPMPC corptrue
Stony Brook Physicians PC
PO Box 1554Stony BrookNY11790201611829medical svcsNYCPMPc corptrue
Healthcare Management Services Inc
PO Box 1554Stony BrookNY11790113247917medical svcsNYCPMPc corptrue
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgstruePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable (3 entries)

Transaction TypeTransactionTypeAmount InvolvedAmountInvolvedMethod Of Amt DeterminationMethodOfAmtDetermination
State of New York
L1075267FMV
Clinical Practice Management Plan
L287498FMV
Clinical Practice Management Plan
M4200000FMV