2024-05-15T10:50:12+00:00 2023-06-30 346565596 ERNST & YOUNG US LLP ONE MANHATTAN WEST NEW YORK NY 100018604 990 2022-07-01 461787308 SB Clinical Practice Management Plan Inc SBCL 6314442055 PO BOX 1554 STONY BROOK NY 11790 Raphael Davis President & CEO 6314442055 2024-05-15 true RAPHAEL DAVIS MD 999009999 Laura Mayo P01962945 2127733000 2022 2023-04-26 12:10:37Z RAPHAEL DAVIS PO BOX 1554 STONY BROOK NY 11790 288324673 false X X 2013 NY RESPONSIBLE FOR THE COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 17 0 0 0 0 0 0 274310812 288258572 22349 20532 0 274333161 288279104 0 0 122875447 135221018 0 0 163693198 177942944 286568645 313163962 -12235484 -24884858 127384073 336748383 125596825 335094785 1787248 1653598 A CLINICAL PRACTICE MANAGEMENT PLAN FOR THE MANAGEMENT OF THE CLINICAL PRACTICE OF FACULTY MEMBERS AT THE MEDICAL SCHOOL AT THE STATE UNIVERSITY OF NEW YORK AT STONY BROOK. false false 306402911 288258572 COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 306402911 true false false false false false false false false true false false true true false false true false false true false false false false false false false false true false false false false false false false false false false false false true true true true false false true X 42 0 true 0 false true CJ false false false false false false false false false false X 17 0 false false false false false false false true true false false true true true true true true false false false NY X SB CLINICAL PRAC MGMT PLAN INC 6314442055 PO BOX 1554 STONY BROOK NY 11790 X ADAM SINGER DIRECTOR 1.0 49.0 X 0 611569 85535 ALAN TURNER DIRECTOR 1.0 49.0 X 0 135589 0 Anissa Abi-Dargham DIRECTOR (effective 10/3/2022) 1.0 49.0 X 0 567316 27211 APOSTOLOS TASSIOPOULOS DIRECTOR 1.0 49.0 X 0 1350245 98001 CAROLYN MILANA SECRETARY 1.0 49.0 X 0 614486 83820 ELAINE GOULD DIRECTOR 1.0 49.0 X 0 785556 71331 EVAN JONES DIRECTOR 1.0 49.0 X 0 1155401 83520 IRIS GRANEK DIRECTOR 1.0 49.0 X 0 456642 80308 JAMES PENNA DIRECTOR 1.0 49.0 X 0 1333260 76761 KENNETH SHROYER DIRECTOR 1.0 49.0 X 0 645098 99289 MARC HALTERMAN DIRECTOR 1.0 49.0 X 0 694763 81014 RAMIN PARSEY DIRECTOR (till 10/3/2022) 1.0 49.0 X 0 486822 33352 RAPHAEL DAVIS CHAIRPERSON 1.0 49.0 X 0 1446918 99499 ROBERT HONKANEN DIRECTOR 1.0 49.0 X 0 815525 78060 SAMUEL RYU DIRECTOR 1.0 49.0 X 0 813457 95838 SERGIO BERGESE DIRECTOR (till 2/16/23) 1.0 49.0 X 0 827432 64695 SYED SHAH DIRECTOR (effective 2/16/23) 1.0 49.0 X 0 548214 69708 TODD GRIFFIN DIRECTOR (TILL 1/1/23) 1.0 49.0 X 0 860365 105071 VINCENT YANG DIRECTOR 1.0 49.0 X 0 826432 90662 WAYNE WALTZER VICE CHAIRPERSON 1.0 49.0 X 0 1123676 100596 WILLIAM BURKE DIRECTOR (EFFECTIVE 1/1/23) 1.0 49.0 X 0 586182 59276 DENNIS CHOI Former Director Thru 6/30/2019 1.0 49.0 X 0 368300 64738 LAWRENCE HURST Former Director Thru 7/1/2021 1.0 49.0 X 0 2100 21084 MARGARET MCGOVERN Former Director Thru 5/1/2018 1.0 49.0 X 0 438124 32306 MARK HENRY FORMER DIRECTOR THRU 7/1/22 1.0 49.0 X 0 604549 86448 MARK TALAMINI Former Director Thru 4/5/2021 1.0 49.0 X 0 0 21084 PATRICIA COYLE Former Director Thru 9/1/2020 1.0 49.0 X 0 359641 75379 PATRICK SIBONY Former Director Thru 3/28/2018 1.0 49.0 X 0 322801 69245 TONG GAN FORMER DIRECTOR THRU 5/23/22 1.0 49.0 X 0 528877 57031 0 19309340 2010862 0 true true false ALLEN NORIN 140 RIVERSIDE DRIVE APT 6D NEW YORK NY 10024 MEDICAL SERVICES 0 0 MANAGEMENT FEES 900099 286144592 286144592 RENTAL 531120 2113980 2113980 0 0 0 0 288258572 0 0 59414 6687 42596 2973 16818 3714 20532 20532 0 0 0 0 0 288279104 288258572 0 20532 X 106285923 100971627 5314296 28935095 27488340 1446755 19453431 19453431 582528 582528 12654 12654 67753794 67753794 0 0 684600 684600 1841416 1841416 5058276 5058276 6838293 6838293 1348139 1348139 3778183 3778183 4048565 4048565 33030245 33030245 MEDICAL EXPENSES 16793705 16793705 CLINICAL PRACTICE RESEARCH 8296278 8296278 DUES AND LICENSE FEES 2277378 2277378 REPAIRS AND MAINTENANCE 6145459 6145459 0 0 0 0 313163962 306402911 6761051 0 11500021 9228720 0 0 0 0 13380 13380 284592695 36756021 32311429 247836674 4505993 4540539 0 0 79053250 75129070 127384073 336748383 9236368 8320744 0 0 116360457 326774041 125596825 335094785 X 1787248 1653598 1787248 1653598 127384073 336748383 X -24884858 -147817 24899025 X false true X true X X X 17 STONY BROOK ANAESTHESIOLOGY UFPC 112553515 9 false 0 0 STONY BROOK CHILDREN'S SERVICE UFPC 112571524 9 false 0 0 STONY BROOK DERMATOLOGY ASSOCIATES UFPC 113011790 9 false 0 0 STONY BROOK EMERGENCY PHYSICIANS UFPC 113066770 9 false 0 0 STONY BROOK FAMILY AND PREVENTIVE MEDICINE UFPC 112552321 9 false 0 0 STONY BROOK INTERNISTS UFPC 112558775 9 false 0 0 NEUROLOGY ASSOCIATES OF STONY BROOK UFPC 112587430 9 false 0 0 NEW YORK SPINE AND BRAIN SURGERY UFPC 112645930 9 false 0 0 UNIVERSITY ASSOCIATES IN OBST & GYNECOLOGY UFPC 112569522 9 false 0 0 STONY BROOK OPHTHALMOLOGY UFPC 112658697 9 false 0 0 STONY BROOK ORTHOPAEDIC ASSOCIATES UFPC 112593061 9 false 0 0 STONY BROOK PATHOLOGISTS UFPC 112647243 9 false 0 0 STONY BROOK PSYCHIATRIC ASSOCIATES UFPC 112590096 9 false 0 0 STONY BROOK RADIATION ONCOLOGY UFPC 112664726 9 false 0 0 STONY BROOK RADIOLOGY UFPC 112548304 9 false 0 0 STONY BROOK SURGICAL ASSOCIATES UFPC 112552333 9 false 0 0 STONY BROOK UROLOGY UFPC 112644371 9 false 0 0 17 0 0 false false false false false false false false false false false false false false false true false Schedule A, Part IV, Section A, Line 1 Supported Orgs Listed By Name PER SB CLINICAL PRACTICE MANAGEMENT PLAN, INC.'S ("CPMP") CERTIFICATE OF INCORPORATION, ONE OF THE PURPOSES OF CPMP'S FORMATION IS "TO FOSTER, SUPPORT, PROMOTE AND PROVIDE ASSISTANCE FOR MEDICAL, EDUCATIONAL AND SCIENTIFIC RESEARCH AND FOR OTHER SIMILAR AND RELATED PROGRAMS AT THE MEDICAL SCHOOL OF THE STATE UNIVERSITY OF NEW YORK AT STONY BROOK." ALL CPMP'S SUPPORTED ORGANIZATIONS, UNIVERSITY FACULTY PRACTICE CORPORATIONS("UFPC") LISTED ON SCH A ATTACHMENT 1, ARE SECTION 509(A)(2) ORGANIZATIONS. CPMP NAMES THEM BY CLASS OR PURPOSE IN ITS CERTIFICATE OF INCORPORATION. 246550560 10627810 235922750 22764621 15038176 7726445 15277514 11090035 4187479 247836674 ADVANCES TO UFPCS 70629070 INVEST IN NICOLLS INDEMNITY 4500000 75129070 CLINICAL PRACTICE RESERVE 91457567 CAPITAL LEASE 208630406 OPERATING LEASE 26686068 326774041 Central America and the Caribbean Investments CAPTIVE INSURANCE 4500000 0 0 0 0 0 0 4500000 0 4500000 true false true false false false Schedule F, Part I, Line 3 Method used to account for expenditures on org's financial statements CENTRAL AMERICA AND THE CARIBBEA X false false false false false false false false false SYED SHAH DIRECTOR (effective 2/16/23) 0 505839 0 39765 0 2610 0 46673 0 23035 0 617922 0 0 SERGIO BERGESE DIRECTOR (till 2/16/23) 0 487858 0 336964 0 2610 0 43023 0 21672 0 892127 0 0 CAROLYN MILANA SECRETARY 0 534776 0 77100 0 2610 0 60352 0 23468 0 698306 0 0 EVAN JONES DIRECTOR 0 786312 0 366479 0 2610 0 61026 0 22494 0 1238921 0 0 ADAM SINGER DIRECTOR 0 570858 0 38101 0 2610 0 62218 0 23317 0 697104 0 0 IRIS GRANEK DIRECTOR 0 379032 0 75000 0 2610 0 57469 0 22839 0 536950 0 0 VINCENT YANG DIRECTOR 0 736867 0 86955 0 2610 0 67824 0 22838 0 917094 0 0 MARC HALTERMAN DIRECTOR 0 617153 0 75000 0 2610 0 59342 0 21672 0 775777 0 0 RAPHAEL DAVIS CHAIRPERSON 0 1417715 0 26593 0 2610 0 75030 0 24469 0 1546417 0 0 WILLIAM BURKE DIRECTOR (EFFECTIVE 1/1/23) 0 570472 0 13100 0 2610 0 37604 0 21672 0 645458 0 0 TODD GRIFFIN DIRECTOR (TILL 1/1/23) 0 780655 0 77100 0 2610 0 82953 0 22118 0 965436 0 0 ROBERT HONKANEN DIRECTOR 0 617323 0 195592 0 2610 0 55941 0 22119 0 893585 0 0 JAMES PENNA DIRECTOR 0 1249050 0 81600 0 2610 0 53979 0 22782 0 1410021 0 0 KENNETH SHROYER DIRECTOR 0 548858 0 93630 0 2610 0 72369 0 26920 0 744387 0 0 Anissa Abi-Dargham DIRECTOR (effective 10/3/2022) 0 567316 0 0 0 0 0 6127 0 21084 0 594527 0 0 RAMIN PARSEY DIRECTOR (till 10/3/2022) 0 482112 0 2100 0 2610 0 11052 0 22300 0 520174 0 0 SAMUEL RYU DIRECTOR 0 718582 0 92265 0 2610 0 72966 0 22872 0 909295 0 0 ELAINE GOULD DIRECTOR 0 715846 0 67100 0 2610 0 47757 0 23574 0 856887 0 0 APOSTOLOS TASSIOPOULOS DIRECTOR 0 1253790 0 93845 0 2610 0 75831 0 22170 0 1448246 0 0 WAYNE WALTZER VICE CHAIRPERSON 0 946675 0 174391 0 2610 0 77627 0 22969 0 1224272 0 0 LAWRENCE HURST Former Director Thru 7/1/2021 0 0 0 2100 0 0 0 0 0 21084 0 23184 0 0 MARK TALAMINI Former Director Thru 4/5/2021 0 0 0 0 0 0 0 0 0 21084 0 21084 0 0 DENNIS CHOI Former Director Thru 6/30/2019 0 363590 0 2100 0 2610 0 40341 0 24397 0 433038 0 0 PATRICK SIBONY Former Director Thru 3/28/2018 0 298251 0 22229 0 2321 0 46550 0 22695 0 392046 0 0 PATRICIA COYLE Former Director Thru 9/1/2020 0 349584 0 7447 0 2610 0 49871 0 25508 0 435020 0 0 MARGARET MCGOVERN Former Director Thru 5/1/2018 0 315290 0 121311 0 1523 0 8026 0 24280 0 470430 0 0 TONG GAN FORMER DIRECTOR THRU 5/23/22 0 375923 0 150996 0 1958 0 34606 0 22425 0 585908 0 0 MARK HENRY FORMER DIRECTOR THRU 7/1/22 0 512249 0 89690 0 2610 0 60880 0 25568 0 690997 0 0 Form 990, Part VI, Line 11b Review of form 990 by governing body AN ELECTRONIC VERSION OF FORM 990 WAS PROVIDED TO THE OFFICERS AND DIRECTORS PRIOR TO FILING. MANAGEMENT PERFORMS A REVIEW OF FORM 990 PRIOR TO FILING, ADDRESSING ANY QUESTIONS MADE BY THE GOVERNING BODY. Form 990, Part VI, Line 12c Conflict of interest policy SB CLINICAL PRACTICE MANAGEMENT PLAN, INC. HAS ADOPTED THE SAME CONFLICT OF INTEREST POLICY AS ITS MEMBER UFPCS. THE PURPOSE OF THE CONFLICT OF INTEREST POLICY IS TO PROTECT SB CLINICAL PRACTICE MANAGEMENT PLAN, INC.'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 ORGANIZATION 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 ORGANIZATION'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. Form 990, Part VI, Line 19 Required documents available to the public NO DOCUMENTS AVAILABLE TO THE PUBLIC. Form 990, Part VIII, Line 2f Other Program Service Revenue - Total Revenue: , Related or Exempt Function Revenue: , Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; Form 990, Part IX, Line 11g Other Fees SCHOOL OF MEDICINE CHARGE - Total Expense: 37606049, Program Service Expense: 37606049, Management and General Expenses: , Fundraising Expenses: ; OTHER OPERATING - Total Expense: 30147745, Program Service Expense: 30147745, Management and General Expenses: , Fundraising Expenses: ; Form 990, Part XI, Line 9 Other changes in net assets or fund balances ALLOCATION TO CLINICAL PRACTICE RESERVE - 25032675; ACO NET ASSETS - -133650; STONY BROOK ACO LLC 101 NICOLLS ROAD STONY BROOK NY 11794 842191009 HEALTHCARE NY 1653598 CPMP NEW YORK STATE 1 COMMERCE PLZ 99 WASHINGTON ALBANY NY 12231 146013200 GOVERNMENT NY 501(c)(1) N/A false STONY BROOK ANAESTHESIOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112553515 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK DERMATOLOGY ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 113011790 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK CLIN PRACT MGMT REALTY CORP PO BOX 1554 STONY BROOK NY 11790 113285712 RLTY HOLDING NY 501(c)(25) CPMP true STONY BROOK SURGICAL HOLDING CORP PO BOX 1554 STONY BROOK NY 11790 116434538 RLTY HOLDING NY 501(c)(25) CPMP true STONY BROOK EMERGENCY PHYSICIANS UFPC PO BOX 1554 STONY BROOK NY 11790 113066770 HEALTHCARE NY 501(c)(3) 10 NYS false SB FAMILY AND PREVENTIVE MEDICINE UFPC PO BOX 1554 STONY BROOK NY 11790 112552321 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK INTERNISTS UFPC PO BOX 1554 STONY BROOK NY 11790 112558775 HEALTHCARE NY 501(c)(3) 10 NYS false NEW YORK SPINE AND BRAIN SURGERY UFPC PO BOX 1554 STONY BROOK NY 11790 112645930 HEALTHCARE NY 501(c)(3) 10 NYS false NEUROLOGY ASSOC OF STONY BROOK UFPC PO BOX 1554 STONY BROOK NY 11790 112587430 HEALTHCARE NY 501(c)(3) 10 NYS false UNIV ASSOC IN OBST & GYNECOLOGY UFPC PO BOX 1554 SOTNY BROOK NY 11790 112569522 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK PATHOLOGISTS UFPC PO BOX 1554 STONY BROOK NY 11790 112647243 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK OPHTHALMOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112658697 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK ORTHOPAEDIC ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112593061 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK CHILDREN'S SERVICE UFPC PO BOX 1554 STONY BROOK NY 11790 112571524 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK PSYCHIATRIC ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112590096 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK RADIATION ONCOLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112664726 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK SURGICAL ASSOCIATES UFPC PO BOX 1554 STONY BROOK NY 11790 112552333 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK UROLOGY UFPC PO BOX 1554 STONY BROOK NY 11790 112644371 HEALTHCARE NY 501(c)(3) 10 NYS false STONY BROOK RADIOLOGY PO BOX 1554 STONY BROOK NY 11790 112548304 HEALTHCARE NY 501(c)(3) 10 NYS false SB HLTHCARE IPA LLC PO BOX 1554 STONY BROOK NY 11790 113499101 HEALTHCARE NY SB CPMP Related false true 1.0000 NICOLLS INDEMNITY SOLUTIONS SPC 981378568 SELF-INSURANCE CPMP C Corporation 16750130 114152274 1.0000 true false false false false false false false false false false false true true false false false false true false STONY BROOK SURGICAL HOLDING CORPORATION L 326675 COST STONY BROOK CPMP REALTY CORPORATION M 21538 COST