2025-05-15T13:00:13-05:00 2024-06-30 161226221 FUSTCHARLES LLP 220 S WARREN STREET SYRACUSE NY 13202 990 2023-07-01 203889761 UPSTATE COMMUNITY MEDICAL PC UPST 3156349272 4900 BROAD ROAD 1507 SYRACUSE NY 13215 EDWARD MARRYOTT EXECUTIVE DIRECTOR 3154925140 2025-05-14 1 1 THOMAS J GIUFRE P00841958 3154463600 2025-05-14 2023 2025-03-06 01:10:19Z EDWARD MARRYOTT 750 EAST ADAMS STREET SYRACUSE NY 13215 36091962 0 X WWW.UPSTATE.EDU/COMMUNITY/UCM/ X 2005 NY THE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. (UCM) IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO ADVANCE THE MISSION OF UPSTATE MEDICAL UNIVERSITY OF NEW YORK. UCM WAS FORMED FOR THE CHARITABLE PURPOSE OF SERVING THE HEALTH CARE NEEDS OF THE COMMUNITY SERVICED BY THE HOSPITAL AND ADVANCING THE CHARITABLE PURPOSE OF THE UNIVERSITY. 1 0 144 0 0 0 0 0 27884935 33898461 0 0 1303838 2193501 29188773 36091962 0 0 0 0 15466752 17066858 0 0 0 13982530 19269419 29449282 36336277 -260509 -244315 7397282 8791769 11258352 12897154 -3861070 -4105385 THE ROLE OF UPSTATE COMMUNITY MEDICAL, P.C. IS TO PROVIDE A COMPREHENSIVE SOURCE FOR ACUTE MEDICAL CARE AND RELATED SERVICES TO UNINSURED AND UNDERINSURED INDIVIDUALS IN THE COMMUNITY. 0 0 9311167 9291499 HOSPITALIST SERVICE - PROVIDED ACUTE MEDICAL CARE FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS. 8163256 8163256 ANESTHESIA SERVICE - PROVIDED ANESTHESIA SERVICES FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS. 3588885 3403430 OB AMBULATORY - PROVIDED OBGYN HEALTHCARE SERVICS FOR THE PATIENTS OF UPSTATE UNIVERSITY HOSPITAL COMMUNITY CAMPUS 13194800 15233777 13194800 15233777 34258108 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 16 0 1 144 1 0 0 0 0 0 0 0 0 0 0 0 0 X 1 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X JONATHAN W FEHLMAN-PRACTICE RESOURCES LLC 3155415648 1001 WEST FAYETTE STREET SUITE 400 SYRACUSE NY 13204 AMY TUCKER MD OFFICER 2.00 40.00 X X 0 514621 0 EDWARD MARRYOTT EXECUTIVE DIRECTOR 40.00 X 195806 0 10069 ALFREDO LOPEZ MD PHYSICIAN 40.00 X 366051 0 16700 ANTHONY M STIRPE PHYSICIAN ASSISTANT 40.00 X 339628 0 17147 KENNETH K RHEE PHYSICIAN 40.00 X 387796 0 17624 FADI N MAKHLOUF MD PHYSICIAN 40.00 X 367542 0 13200 KRISTINA A BYRNE PHYSICIAN 40.00 X 430153 0 16155 MATTHEW GLIDDEN FORMER OFFICER 0.00 40.00 X 0 422098 0 2086976 936719 90895 54 1 1 0 CHAG ANESTHESIA GROUP 5000 BRITTONFIELD PARKWAY EAST SYRACUSE NY 13057 PROFESSIONAL MEDICAL SERVICES 5732738 DEPARTMENT OF MEDICINE MEDICAL SERVICE 550 E GENESEE ST SUITE 201 SYRACUSE NY 13202 PROFESSIONAL MEDICAL SERVICES 4939294 FAMILYCARE MEDICAL GROUP PC 1001 W FAYETTE ST SYRACUSE NY 13204 PROFESSIONAL MEDICAL SERVICES 961904 PRACTICE RESOURCES LLC 1001 W FAYETTE ST SYRACUSE NY 13204 ADMINISTRATIVE AND BILLING SERVICES 747907 UNIVERSITY OBGYN ASSOCIATES INC 736 IRVING AVE 3 WEST TOWER SYRACUSE NY 13210 PROFESSIONAL MEDICAL SERVICES 203346 6 PROFESSIONAL SERVICE AGREEMENT - 621110 27050949 27050949 PROFESSIONAL SERVICES 621110 6847512 6847512 33898461 PROFESSIONAL SERVICE REIMBURSEMEN 900099 2184972 2184972 RECOVERY OF BAD DEBTS 900099 8529 8529 2193501 36091962 36091962 0 0 X 205875 205875 14517857 14228657 289200 417122 417122 945430 923575 21855 980574 944027 36547 169200 169200 82763 82763 52291 52291 16758005 15717715 1040290 32055 675 31380 458559 416742 41817 195075 179643 15432 2619 695 1924 51156 51156 758788 688207 70581 BILLING FEES 641592 641592 PERMITS, LICENSES, DUES 41279 40321 958 MISCELLANEOUS 26037 7981 18056 36336277 34258108 2078169 0 2287820 793577 310750 346779 130929 129463 94395 94395 0 0 4667783 7521950 7397282 8791769 787450 1962362 10470902 10934792 11258352 12897154 X 10 10 90 90 -3861170 -4105485 -3861070 -4105385 7397282 8791769 -244315 0 X 0 0 0 X 250594 250594 25668422 26003580 27538353 27884935 33898461 140993751 25919016 26003580 27538353 27884935 33898461 141244345 0 0 0 141244345 513036 676758 578646 1303838 2193501 5265779 26432052 26680338 28116999 29188773 36091962 146510124 0.96410 0.97010 0.00000 X 94395 94395 0 0 DUE FROM UNIVERSITY HOSPITAL 4419093 OTHER RECEIVABLES 3102857 7521950 DUE TO RELATED PARTIES 10934792 10934792 X 0 0 0 0 0 0 0 0 0 AMY TUCKER MD OFFICER 0 514621 0 0 0 0 0 0 0 0 0 514621 0 0 KRISTINA A BYRNE PHYSICIAN 429777 0 0 0 376 0 13200 0 2955 0 446308 0 0 0 MATTHEW GLIDDEN FORMER OFFICER 0 422098 0 0 0 0 0 0 0 0 0 422098 0 0 KENNETH K RHEE PHYSICIAN 384750 0 0 0 3046 0 13200 0 4424 0 405420 0 0 0 ALFREDO LOPEZ MD PHYSICIAN 363629 0 0 0 2422 0 13200 0 3500 0 382751 0 0 0 FADI N MAKHLOUF MD PHYSICIAN 366629 0 0 0 913 0 13200 0 0 0 380742 0 0 0 ANTHONY M STIRPE PHYSICIAN ASSISTANT 339045 0 0 0 583 0 13200 0 3947 0 356775 0 0 0 EDWARD MARRYOTT EXECUTIVE DIRECTOR 194615 0 0 0 1191 0 7785 0 2284 0 205875 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B A COPY OF FORM 990 WAS DISTRIBUTED FOR REVIEW BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE COMPANY BYLAWS REFLECT THAT THE BOARD ENFORCES A POLICY THAT REQUIRES ALL DIRECTORS, OFFICERS, AND OTHER PERSONS IN A POSITION TO INFLUENCE CORPORATE DECISIONS TO DISCLOSE ACTUAL OR POTENTIAL CONFLICTS OF INTEREST AND THE PROCESS THAT SHALL BE FOLLOWED WHEN A DISCLOSURE IS MADE. ENHANCEMENTS TO THE POLICY CONTINUE TO BE MADE. FORM 990, PART VI, SECTION B, LINE 15 SALARY AND BONUS OR INCENTIVE COMPENSATION IS DETERMINED BASED ON A REVIEW OF RELEVANT MARKET DATA. PERIODIC REVIEWS ARE CONDUCTED AS APPROPRIATE FOR REASONABLENESS, VALUATION, PERFORMANCE, AND COMPLIANCE WITH CONTRACTUAL REQUIREMENTS. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONSULTING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 27,953. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,953. RECRUITING: PROGRAM SERVICE EXPENSES 1,462. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,462. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1,012,337. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,012,337. MEDICAL PROFESSIONAL PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 15,716,253. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 15,716,253. SUNY UPSTATE UNIVERSITY HOSPITAL 750 E ADAMS STREET SYRACUSE NY 13210 161469571 PATIENT CARE NY 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 0 SUNY UPSTATE UNIVERSITY HOSPITAL L 27050949 PROFESSIONAL SERVICES AGREEMENT SUNY UPSTATE UNIVERSITY HOSPITAL M 1012337 ADMIN SERVICES AGREEMENT