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PHYSICIANS OF UNIVERSITY HOSPITAL PC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
PHYSICIANS OF UNIVERSITY HOSPITAL PC (EIN 20-0096809)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-15
IRS object ID
201343199349301214
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2013-11-15T07:26:02-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WithumSmithBrown PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1465 South St Ste 200AddressLine1
CityMorristownCity
StateNJState
ZIP Code079606497ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN200096809EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PHYSICIANS OF UNIVERSITY HOSPITAL PCBusinessNameLine1
FieldValueIRS element (for citing)
In Care Of Name% THOMAS RECAInCareOfName
Name ControlPHYSNameControl
Phone7182264597Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11 EDGEWATER PLAZAAddressLine1
Address Line2SuiteAddressLine2
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN STIEGERName
TitleofficerTitle
Phone9738989494Phone
Date Signed2013-11-12DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAnthony J PanicoName
Phone9738989494Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARK P JARRETT MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1475 SEAVIEW AVENUEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode
FieldValueIRS element (for citing)
Gross Receipts65674745GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2003YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION PROVIDES MEDICALLY NECESSARY HEALTHCARE SERVICES IN FURTHERANCE OF THE CHARITABLE PURPOSES OF STATEN ISLAND UNIVERSITY HOSPITAL; A RELATED IRC SECTION 501(C)(3) TAX-EXEMPT hospital.ActivityOrMissionDescription
Nbr Voting Members Governing Body2NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees136TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year53536652ProgramServiceRevenuePriorYear
Program Service Revenue CY65674745ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year53536652TotalRevenuePriorYear
Total Revenue Current Year65674745TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year6500GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year18537864SalariesEtcPriorYear
Salaries Etc Current Year20871636SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year30900153OtherExpensePriorYear
Other Expenses Current Year45681616OtherExpensesCurrentYear
Total Expenses Prior Year49444517TotalExpensesPriorYear
Total Expenses Current Year66553252TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4092135RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-878507RevenuesLessExpensesCY
Total Assets BOY4233787TotalAssetsBOY
Total Assets EOY3420254TotalAssetsEOY
Total Liabilities BOY109917TotalLiabilitiesBOY
Total Liabilities EOY174891TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4123870NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3245363NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTHE 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.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense59897929Expense
Grants0Grants
Revenue65674745Revenue
DescriptionEXPENSES 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. PLEASE REFER TO SCHEDULE O FOR THE ORGANIZATION'S COMMUNITY BENEFIT STATEMENT.Description
Total Program Service Expense59897929TotalProgramServiceExpense
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 EntityfalseRelatedOrgControlledEntity
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109615NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees136NumberOfEmployees
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
Excess Business HoldingsfalseExcessBusinessHoldings
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members2NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholderstrueMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
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 VenturetrueInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonTHOMAS RECANamePerson
Telephone Number7182261148TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11 EDGEWATER PLAZAAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10305ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIXInfoInScheduleOPartVII

Form990 Part VII Section A Form990PartVIISectionA (7 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MARK P JARRETT MD
PRESIDENT - TRUSTEE3.047.0XX066528047159
FRANK FORTE
SECRETARY - TRUSTEE2.048.0XX049144348109
NICOLE BERWALD MD
PHYSICIAN50.0340644027269X
BORIS KHODORKOVSKY MD
PHYSICIAN50.0332301034558X
CHRISTOPHER GRAZIANO MD
PHYSICIAN50.0331104037352X
ABBAS HUSAIN MD
PHYSICIAN50.0301093027657X
JOHN M CALABRO MD
PHYSICIAN50.0287870031944X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1593012TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs1156723TotalReportableCompFrmRltdOrgs
Total Other Compensation254048TotalOtherCompensation
Number Individuals GT100 K56NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
METROPOLITAN OBGYN ASSOCIATES PC
5724 NEW UTRECHT AVENUEBROOKLYNNY11219MEDICAL234332
ISLAND MEDICAL SPECIALISTS LLC
347 EDISON AVENUESTATEN ISLANDNY10306STAFFING130148
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Total Contributions0TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICE REVENUEDescription
Business Code541900BusinessCode
Total Revenue Column65674745TotalRevenueColumn
Related Or Exempt Function Income65674745RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue65674745TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

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 Column65674745TotalRevenueColumn
Related Or Exempt Function Income65674745RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

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)
Total0Total

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total17617976Total
Program Services15856178ProgramServices
Management And General1761798ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total566344Total
Program Services509710ProgramServices
Management And General56634ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1577962Total
Program Services1420166ProgramServices
Management And General157796ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1109354Total
Program Services998419ProgramServices
Management And General110935ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6366Total
Program Services5729ProgramServices
Management And General637ManagementAndGeneral

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)
Total39268401Total
Program Services35341561ProgramServices
Management And General3926840ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total23100Total
Program Services20790ProgramServices
Management And General2310ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total648499Total
Program Services583649ProgramServices
Management And General64850ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total36220Total
Program Services32598ProgramServices
Management And General3622ManagementAndGeneral

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1516659Total
Program Services1364993ProgramServices
Management And General151666ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total837Total
Program Services753ProgramServices
Management And General84ManagementAndGeneral

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)
Total1543189Total
Program Services1388870ProgramServices
Management And General154319ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
MEDICAL SUPPLIES60077754069960078
DUES, LICENSES & SUBSCRIPTIONS58812529315881
UTILITIES55810502295581
PAYROLL SERVICES48690438214869

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1874256Total
Program Services1686833ProgramServices
Management And General187423ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total66553252Total
Program Services59897929ProgramServices
Management And General6655323ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY4231107BOY
EOY3368242EOY

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)
BOY2680BOY
EOY52012EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY4233787BOY
EOY3420254EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY109917BOY
EOY174891EOY

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)
BOY109917BOY
EOY174891EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4123870BOY
EOY3245363EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4123870BOY
EOY3245363EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4233787BOY
EOY3420254EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-878507ReconcilationRevenueExpenses
Method Of Accounting CashXMethodOfAccountingCash
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredfalseFederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3XSupportingOrganization509a3
Supporting Org509a3 Type1XSupportingOrg509a3Type1
Certification CheckboxXCertificationCheckbox
Written IRS DeterminationXWrittenIRSDetermination
Contrib By Controlling IndividualfalseContribByControllingIndividual
Contribution By Related PartyfalseContributionByRelatedParty
Contrib By35 Controlled EntityfalseContribBy35ControlledEntity

Supported Org Information SupportedOrgInformation

Name Name

FieldValueIRS element (for citing)
Business Name Line1STATEN ISLAND UNIVERSITY HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
EIN112868878EIN
Type Of Organization03TypeOfOrganization
Listed In Governing DoctrueListedInGoverningDoc
Supported Organization NotifiedtrueSupportedOrganizationNotified
Organized In UStrueOrganizedInUS
Amount$0Amount
FieldValueIRS element (for citing)
Total Number Of Supported Orgs1TotalNumberOfSupportedOrgs
Sum Of Amounts0SumOfAmounts

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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 (7 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
MARK P JARRETT MD
PRESIDENT - TRUSTEE061203700053243031154016005071243900
FRANK FORTE
SECRETARY - TRUSTEE04914430000022000026109053955200
NICOLE BERWALD MD
PHYSICIAN3012240391740246098000174690367913000
BORIS KHODORKOVSKY MD
PHYSICIAN2926620394360203098000247580366859000
CHRISTOPHER GRAZIANO MD
PHYSICIAN2967260341530225098000275520368456000
ABBAS HUSAIN MD
PHYSICIAN2749870259150191098000178570328750000
JOHN M CALABRO MD
PHYSICIAN2709490167060215098000221440319814000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
IdentifierCOMPENSATION INFORMATIONIdentifier
Return ReferenceSCHEDULE J, PART I; QUESTION 7ReturnReference
ExplanationON 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, PART II, COLUMN B(II).Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (10 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION A; QUESTIONS 6 & 7STATEN 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. North Shore-Long Island Jewish Health Care, Inc. ("Health Care") IS THE SOLE MEMBER OF STATEN ISLAND UNIVERSITY HOSPITAL.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 11bTHE ORGANIZATION'S FEDERAL FORM 990 WAS PROVIDED TO EACH VOTING MEMBER OF ITS GOVERNING BODY (ITS BOARD OF TRUSTEES) FOR REVIEW PRIOR TO THE FILING WITH THE INTERNAL REVENUE SERVICE ("IRS"). AS PART OF THE ORGANIZATION'S FEDERAL FORM 990 TAX RETURN PREPARATION PROCESS THE ORGANIZATION HIRED A PROFESSIONAL CPA FIRM WITH EXPERIENCE AND EXPERTISE IN BOTH HEALTHCARE AND NOT-FOR-PROFIT TAX RETURN PREPARATION TO PREPARE THE FEDERAL FORM 990. THE CPA FIRM'S TAX PROFESSIONALS WORKED CLOSELY WITH THE ORGANIZATION'S FINANCE PERSONNEL AND OTHER INDIVIDUALS TO OBTAIN THE INFORMATION NEEDED IN ORDER TO PREPARE A COMPLETE AND ACCURATE TAX RETURN. THE CPA FIRM PREPARED A DRAFT FEDERAL FORM 990 AND FURNISHED IT TO THE ORGANIZATION'S internal finance personnel FOR REVIEW. THE ORGANIZATION'S internal finance personnel REVIEWED THE DRAFT FEDERAL FORM 990 AND DISCUSSED QUESTIONS AND COMMENTS WITH THE CPA FIRM. REVISIONS WERE MADE TO THE DRAFT FEDERAL FORM 990 WHERE NECESSARY AND A FINAL DRAFT WAS provided TO EACH VOTING MEMBER OF THE ORGANIZATION'S BOARD OF TRUSTEES PRIOR TO THE FILING WITH THE IRS.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 12The North Shore-Long Island Jewish Health System ("Health System") has several control mechanisms to mitigate conflicts of interest. The Health System's 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 Health System business in a manner that places the interests of the Health System ahead of their personal interests. In addition, the Health System 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 the Health System 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 the Health System's Audit and Corporate Compliance Committee and other applicable committees. In addition, the Health System 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.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION B; QUESTION 15THE BY-LAWS OF THE HEALTH SYSTEM 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 THE SYSTEM 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.
DISCLOSURE INFORMATIONCORE FORM, PART VI, SECTION C; QUESTION 19CURRENTLY THE ORGANIZATION PROVIDES GOVERNANCE DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS TO THE PUBLIC UPON REQUEST.
RELATED HOURS INFORMATIONCORE FORM, PART VII, SECTION AThis organization is affiliated within North Shore - Long Island Jewish Health System (the "Health System"). The Officers, Directors and Trustees listed on Schedule J hold similar positions with both this organization and other affiliates of the Health System, 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 the entire Health System 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 the Health System and its affiliates.
OTHER FEES FOR SERVICES FOR NON-EMPLOYEESFORM 990 PART IX LINE 11GDESCRIPTION:PHYSICIAN FEES TOTAL FEES:31107006
OTHER FEES FOR SERVICES FOR NON-EMPLOYEESFORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES TOTAL FEES:4308593
OTHER FEES FOR SERVICES FOR NON-EMPLOYEESFORM 990 PART IX LINE 11GDESCRIPTION:BILLING & CODING FEES TOTAL FEES:3833068
OTHER FEES FOR SERVICES FOR NON-EMPLOYEESFORM 990 PART IX LINE 11GDESCRIPTION:CONSULTING FEES TOTAL FEES:19734

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII (36 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivitiesPrimaryActivitiesLegal Domicile StateLegalDomicileStateExempt Code SectionExemptCodeSectionPublic Charity StatusPublicCharityStatusBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Controlled OrgControlledOrg
CHAPS Community Health Center Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305113345477InactiveNY501(C)(3)9SIUHfalse
Feinstein Institute for Medical Research
972 Brush Hollow RdWestburyNY11590112673595ResearchNY501(C)(3)4NS-LIJ HSfalse
Forest Hills Hospital
972 Brush Hollow RdWestburyNY11590112163522HealthCareNY501(C)(3)3NS-LIJ HCfalse
Franklin Hospital
972 Brush Hollow RdWestburyNY11590112296824HealthCareNY501(C)(3)3NS-LIJ HCfalse
Glen Cove Hospital
972 Brush Hollow RdWestburyNY11590111633487HealthCareNY501(C)(3)3NS-LIJ HCfalse
Hillside Hospital Houses Inc
972 Brush Hollow RdWestburyNY11590112113949Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
Hospice Care Network
99 Sunnyside BlvdWoodburyNY11797112925757HospiceNY501(C)(3)9NS-LIJ HSfalse
Huntington Hospital
270 Park AvenueHuntingtonNY11743111630914HealthCareNY501(C)(3)3NS-LIJ HCfalse
Huntington Hosp Dolan Family Health Ctr
284 Pulaski RdGreenlawnNY11740113368503HealthCareNY501(C)(3)3Huntingtonfalse
LIJ Foundation
972 Brush Hollow RdWestburyNY11590112661239support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
Long Island Jewish Medical Center
972 Brush Hollow RdWestburyNY11590112241326HealthCareNY501(C)(3)3NS-LIJ HCfalse
LIJ Medical Center at Home Pharmacy
972 Brush Hollow RdWestburyNY11590113251128support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore Community Services Inc
972 Brush Hollow RdWestburyNY11590237273200Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
North Shore University Hospital
972 Brush Hollow RdWestburyNY11590111562701HealthCareNY501(C)(3)3NS-LIJ HCfalse
NS Univ Hospital at Glen Cove Housing
972 Brush Hollow RdWestburyNY11590237010468Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
North Shore University Hospital Housing
972 Brush Hollow RdWestburyNY11590112171903Housing CompNY501(C)(2)N/ANS-LIJ HSfalse
NSLIJ STERN FAMILY CENTER FOR REHAB
972 Brush Hollow RdWestburyNY11590237007485Nursing HomeNY501(C)(3)9NS-LIJ HCfalse
North Shore-LIJ Health Care Inc
972 Brush Hollow RdWestburyNY11590112965586support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore-LIJ Health System
972 Brush Hollow RdWestburyNY11590113418133support orgNY501(C)(3)11, TYPE INAfalse
North Shore-LIJ Health System Foundation
972 Brush Hollow RdWestburyNY11590112965575FundraisingNY501(C)(3)7NS-LIJ HSfalse
North Shore-LIJ Health Sys Laboratories
972 Brush Hollow RdWestburyNY11590113412370support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
North Shore-LIJ Medical Care Centers
972 Brush Hollow RdWestburyNY11590113473923support orgNY501(C)(3)11, TYPE INS-LIJ HSfalse
Plainview Hospital
972 Brush Hollow RdWestburyNY11590113241243HealthCareNY501(C)(3)3NS-LIJ HCfalse
SIUH Systems Inc
475 Seaview AvenueStaten IslandNY10305061074604FundraisingNY501(C)(3)7NS-LIJ HCfalse
Southside Hospital
972 Brush Hollow RdWestburyNY11590111667761HealthCareNY501(C)(3)3NS-LIJ HCfalse
SSH Inc
972 Brush Hollow RdWestburyNY11590112774102support orgNY501(C)(3)11, TYPE ISOUTHSIDEfalse
Staten Island Univ Hospital Foundation
360 Seaview AvenueStaten IslandNY10305870765787FundraisingNY501(C)(3)7SIUHfalse
THE HEART INSTITUTE
475 SEAVIEW AVENUESTATEN ISLANDNY10305311757254SUPPORT ORGNY501(C)(3)11, TYPE INAfalse
LENOX HILL HOSPITAL
100 EAST 77 STREETNEW YORKNY10021131624070HEALTHCARENY501(C)(3)3NS-LIJ HCfalse
LHH CORPORATION
100 EAST 77 STREETNEW YORKNY10021133272016SUPPORT ORGNY501(C)(3)11, TYPE INS-LIJ HSfalse
STATEN ISLAND UNIVERSITY HOSPITAL
475 Seaview AvenueSTATEN ISLANDNY10305112868878HEALTHCARENY501(C)(3)3NS-LIJ HSfalse
THE ELMEZZI GRAD SCHOOL OF MOLECULAR MED
972 BRUSH HOLLOW RDWESTBURYNY11590113284934GRADUATE SCHNY501(C)(3)2NS-LIJ HSfalse
SPORTS PHYSICAL THERAPY AND REHAB SVCS
972 BRUSH HOLLOW RDWESTBURYNY11590061655704HEALTHCARENY501(C)(3)9LIJfalse
NORTH SHORE - LIJ ALLIANCE
972 BRUSH HOLLOW RDWESTBURYNY11590263727582HEALTHCARENY501(C)(3)3NAfalse
THE LONG ISLAND HOME
400 SUNRISE HIGHWAYAMITYVILLENY11701112837244HEALTHCARENY501(c)(3)3LHH CORPfalse
THE LONG ISLAND HOME FOUNDATION
400 SUNRISE HIGHWAYAMITYVILLENY11701112049038supportNY501(C)(3)11, TYPE 1LHH CORPfalse

Form990 Schedule R Part III Form990ScheduleRPartIII (2 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Disproportionate AllocationsDisproportionateAllocations
KRASNOFF CONS SVCS
972 Brush Hollow ROADWESTBURYNY11590262838027CONSULTINGNYCARE MGT GROUPfalse
LONG ISL BEHAV HLTH
972 BRUSH HOLLOW RDWESTBURYNY11590453572263STATISTICSNYNS-LIJ HCfalse

Form990 Schedule R Part IV Form990ScheduleRPartIV (64 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeEINEINPrimary ActivityPrimaryActivityLegal Domicile StateLegalDomicileStateBusiness Name Line1DirectControllingEntityName/BusinessNameLine1Type Of EntityTypeOfEntityControlled OrgControlledOrgAddress Line1AddressForeign/AddressLine1CityAddressForeign/CityProvince Or StateAddressForeign/ProvinceOrStateCountryAddressForeign/CountryPostal CodeAddressForeign/PostalCodeLegal Domicile Foreign CountryLegalDomicileForeignCountry
Adv Heart Phys & Surgeons Network PC
130 East 77th St 4th FloorNew YorkNY10021133853125Medical ServicesNYLENOX HILLC CORPORATIONfalse
Adv Imag & Rad of Lenox Hill Hosp PC
100 East 77th StNew YorkNY10021200719612Medical ServicesNYLENOX HILLC CORPORATIONfalse
Aletta Corporation
972 Brush Hollow RdWestburyNY11590112622371Physician SVCs.NYSOUTHSIDEC CORPORATIONfalse
Autoimmune Research Therapeutics
972 Brush Hollow RdWestburyNY11590270701489InactiveNYRESEARCHC CORPORATIONfalse
Care Management Group of Greater NY
972 Brush Hollow RdWestburyNY11590113336381Business ServicesNYNSH ENTERPRISESC CORPORATIONfalse
Emergency Med Svcs of Staten Island PC
1 Edgewater Plaza 6th floorStaten IslandNY10305134200899Medical ServiCESNYSIUHC CORPORATIONfalse
Goethals Radiology PC
500 Seaview AveStaten IslandNY10305200010287Radiology SVCs.NYSIUHC CORPORATIONfalse
Lenox Hill Cardiology Associates PC
100 East 77th StNew YorkNY10021133385163Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Int Card & Vasc Svcs PC
130 East 77th St 9th floorNew YorkNY10021201435770Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Pathology PC
100 East 77th StNew YorkNY10021133644370Medical ServiCESNYLENOX HILLC CORPORATIONfalse
Lenox Hill Phy Hospital Org Inc
122 East 76th St suite 3-aNew YorkNY100212834133775996Managed CareNYLENOX HILLC CORPORATIONfalse
Lenox otolaryngology head & neck
186 East 76th St 2nd floorNew YorkNY10021208784395Medical ServicesNYLENOX HILLC CORPORATIONfalse
Manhattan Min Inv and Bar Surgery PC
186 East 76th St 1st FloorNew YorkNY10021200250107Medical ServicesNYLENOX HILLC CORPORATIONfalse
North Shore Health Enterprises
972 Brush Hollow RdWestburyNY11590061605319Holding CompNYNSHS ENTERPRISEC CORPORATIONfalse
NS Health System Enterprises
972 Brush Hollow RdWestburyNY11590113316922Holding CompNYNS-LIJ HSC CORPORATIONfalse
North Shore IPA 5 Inc
972 Brush Hollow RdWestburyNY11590113383468Business ServicesNYNS-LIJ HCC CORPORATIONfalse
NS Radiology at Glen Cove PC
972 Brush Hollow RdWestburyNY11590113301179Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Health System IPA #1
972 Brush Hollow RdWestburyNY11590113533659Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #2
972 Brush Hollow RdWestburyNY11590113533670Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #3
972 Brush Hollow RdWestburyNY11590113533678Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #4
972 Brush Hollow RdWestburyNY11590113533677Health CareNYLIJC CORPORATIONfalse
NS-LIJ Health System IPA #5
972 Brush Hollow RdWestburyNY11590113533675Health CareNYLIJC CORPORATIONfalse
NS-LIJ Medical Gr at Huntington PC
972 Brush Hollow RdWestburyNY11590274384049Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Gr at North Nassau PC
972 Brush Hollow RdWestburyNY11590274384146Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Gr at Syosset PC
972 Brush Hollow RdWestburyNY11590273957752Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Medical Group PC
972 Brush Hollow RdWestburyNY11590274384249Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ Network Inc
972 Brush Hollow RdWestburyNY11590320257193Support ServicesNYNS-LIJ HSC CORPORATIONfalse
NS-LIJ Phys Ins Co Risk Ret Gp
100 Bank StBurlingtonVT05401261487515INSURANCEVTNS-LIJ HCC CORPORATIONfalse
North Shore-LIJ Physicians Group PC
972 Brush Hollow RdWestburyNY11590274384326Medical ServicesNYNSUHC CORPORATIONfalse
North Shore-LIJ Radiology Services PC
972 Brush Hollow RdWestburyNY11590223970667Medical ServicesNYNSUHC CORPORATIONfalse
North Shore-LIJ Service Alliance Inc
972 Brush Hollow RdWestburyNY11590263651575Support ServicesNYNAC CORPORATIONfalse
Ocean Breeze Home Care Agency
1 Edgewater Plaza 6th FloorStaten IslandNY10305133773601InactiveNYOVMC CORPORATIONfalse
Ocean View Management INC
1 Edgewater Plaza 6th FloorStaten IslandNY10305133138888Management Svcs.NYSIUHC CORPORATIONfalse
Palliative Care Medical Services PC
99 Sunnyside BlvdWoodburyNY11797273957835Medical ServicesNYHOSPICEC CORPORATIONfalse
Park Lenox Emergency Medicine PC
100 East 77th StNew YorkNY10021262661082Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Medical PC
100 East 77th StNew YorkNY10021133575380Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox OBGYN PC
130 East 77th St 2nd FloorNew YorkNY10021133596988Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Orthopedics PC
100 East 77th StNew YorkNY10021264634966Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Pediatrics PC
100 East 77th StNew YorkNY10021133755683Medical ServicesNYLENOX HILLC CORPORATIONfalse
Park Lenox Surgical PC
130 East 77th St 13th FloorNew YorkNY10021133397814Medical ServicesNYLENOX HILLC CORPORATIONfalse
Regency Alliance Services Inc
1 Edgewater Plaza 6th FloorStaten IslandNY10305133277698inactiveNYOVMC CORPORATIONfalse
Regional Insurance Company LTD
insuranceNS-LIJ HCC CORPORATIONfalse41 Cedar AveHamiltonBERMUDABDHM 12BD
Regioncare Inc
972 Brush Hollow RdWestburyNY11590113052191HomecareNYNSHS ENTERPRISEC CORPORATIONfalse
Staten Island Hospitalists PC
475 Seaview AveStaten IslandNY10305331010283Medical ServicesNYSIUHC CORPORATIONfalse
Staten Island Imaging Corp
1 Edgewater Plaza 6th FloorStaten IslandNY10305133615474InactiveNYOVMC CORPORATIONfalse
Staten Island Medical Intensivist PC
501 Seaview Ave Suite 102Staten IslandNY10305043716494Medical ServicesNYSIUHC CORPORATIONfalse
Staten Island Neonatology PC
500 Seaview AveStaten IslandNY10305133375474Medical ServicesNYSIUHC CORPORATIONfalse
SIUH Perinatology PC
475 Seaview AveStaten IslandNY10305134107082Medical ServicesNYSIUHC CORPORATIONfalse
United Medical Surgical PC
256 Mason Ave BLDG B 2nd FLStaten IslandNY10305134038780Surgical ServicesNYSIUHC CORPORATIONfalse
Univ Ph OncHematology Gp PC
500 Seaview AveStaten IslandNY10305133642729Medical ServicesNYSIUHC CORPORATIONfalse
Verrazano Radiology Assoc PC
500 Seaview Ave Suite 200Staten IslandNY10305200011201Radiology Svcs.NYSIUHC CORPORATIONfalse
Vivohealth Inc
972 Brush Hollow RdWestburyNY11590264118016InactiveNYNSH ENTERPRISEC CORPORATIONfalse
PARK LENOX PSYCHIATRY PC
130 EAST 77TH STREETNEW YORKNY10021133424466Medical ServicesNYLENOX HILLc corporationfalse
NS-LIJ CARDIOVASCULAR MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078717Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ CARDIOLOGY PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078531Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ HEART SURGERY PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078838Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ INTERNAL MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078361Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ MEDICAL GROUP URGENT MED CARE PC
972 BRUSH HOLLOW RDWESTBURYNY11590275078426Medical ServicesNYNSUHC CORPORATIONfalse
LENOX HILL HOSPITAL MEDICAL PC
972 BRUSH HOLLOW RDWESTBURYNY11590452661543Medical ServicesNYlenoxC CORPORATIONfalse
NS-LIJ MEDICAL PC
972 BRUSH HOLLOW RDWESTBURYNY11590453023019Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ OCCUPATIONAL MEDICINE PC
972 BRUSH HOLLOW RDWESTBURYNY11590451004103Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ OB-GYN PC
972 Brush Hollow RdWestburyNY11590461382916Medical ServicesNYnsuhc corporationfalse
NS-LIJ ANESTHESIOLOGY PC
972 BRUSH HOLLOW RDWESTBURYNY11590461617561Medical ServicesNYNSUHC CORPORATIONfalse
NS-LIJ HEALTH PLANS INC
972 Brush Hollow RdWestburyNY11590461617516Medical ServicesNYNS-LIJ HCc corporationfalse
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 OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgstruePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeestrueSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

Form990 Schedule R Part VII Form990ScheduleRPartVII

FieldValueIRS element (for citing)
IdentifierTRANSACTIONS WITH RELATED ORGANIZATIONSIdentifier
Return ReferenceSCHEDULE R, PART VReturnReference
ExplanationTHIS ORGANIZATION IS AN AFFILIATE OF North Shore - long Island Jewish Health System ("sYSTEM"). ORGANIZATIONS WITHIN THE SYSTEM 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.Explanation