PECONIC BAY FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRAC: Form 990EZ, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
PECONIC BAY FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRAC (EIN 87-1869119)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-10
IRS object ID
202323149349202562
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-10T13:37:57-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt
Return Type990EZReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN871869119EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PECONIC BAY FACULTY MEDICAL AFFILIATESBusinessNameLine1Txt
Business Name Line2UNIVERSITY FACULTY PRACTICE CORPORATIONBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% NORTHWELL HEALTH INCInCareOfNm
Business Name ControlPECOBusinessNameControlTxt
Phone5163216058PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1972 BRUSH HOLLOW RD 5TH FLAddressLine1Txt
CityWESTBURYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11590ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELE L CUSACKPersonNm
Person TitleEVP & CFOPersonTitleTxt
Phone5163216058PhoneNum
Signature2023-11-06SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHELE LPersonFirstNm
Person LastCUSACKPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$0GrossReceiptsAmt
Cost Or Other Basis Expense Sale$0CostOrOtherBasisExpenseSaleAmt
Gain Or Loss From Sale Of Assets$0GainOrLossFromSaleOfAssetsAmt
Special Events Direct Expenses$0SpecialEventsDirectExpensesAmt
Special Events Net Income Loss$0SpecialEventsNetIncomeLossAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt
Gross Profit Loss Sls Of Invntry$0GrossProfitLossSlsOfInvntryAmt
Total Revenue$0TotalRevenueAmt
Salaries Other Comp Empl Bnft$0SalariesOtherCompEmplBnftAmt
Total Expenses$0TotalExpensesAmt
Excess Or Deficit For Year$0ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$0NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$0NetAssetsOrFundBalancesEOYAmt
Cash Savings And InvestmentsCashSavingsAndInvestmentsGrp

Land And Buildings LandAndBuildingsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total Detail OtherAssetsTotalDetail

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Primary Exempt PurposePECONIC BAY FACULTY MEDICAL AFFILIATES, UNIVERSITY FACULTY PRACTICE CORPORATION (THE CORPORATION) FUNCTIONS AS AN EXTENSION OF THE HOSPITAL BY BRINGING MEDICAL CARE TO COMMUNITY SETTINGS; PROVIDING CARE TO MEDICARE, MEDICAID AND OTHER PATIENTS; AND APPLYING THE HOSPITAL'S GOLD STANDARD FINANCIAL ASSISTANCE POLICY TO THOSE WHO NEED ASSISTANCE.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp

FieldValueIRS element (for citing)
Description Program Srvc AccomN/ADescriptionProgramSrvcAccomTxt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (6 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
David Battinelli MD
PRESIDENT, SECRETARY & TRUSTEE2.0$0$0$0
Lawrence Smith MD
VP & TRUSTEE2.0$0$0$0
Michael Dowling
CEO2.0$0$0$0
Michele Cusack
CFO & TREASURER2.0$0$0$0
Deborah Schiff
SVP2.0$0$0$0
Laurence Kraemer
Asst Secretary, EVP & General2.0$0$0$0
FieldValueIRS element (for citing)
Activities Not Previously RptfalseActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not RptfalseChgMadeToOrgnzngDocNotRptInd
Organization Had UBIfalseOrganizationHadUBIInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Organization Dissolved EtcfalseOrganizationDissolvedEtcInd
Made Loans To From OfficersfalseMadeLoansToFromOfficersInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonNORTHWELL HEALTH INCPersonNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1972 BRUSH HOLLOW RD 5TH FLAddressLine1Txt
CityWESTBURYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP11590ZIPCd
FieldValueIRS element (for citing)
Phone5163216058PhoneNum
FieldValueIRS element (for citing)
Foreign Financial AccountfalseForeignFinancialAccountInd
Foreign OfficefalseForeignOfficeInd
Donor Advised FndsfalseDonorAdvisedFndsInd
Operate HospitalfalseOperateHospitalInd
Tanning Services ProvidedfalseTanningServicesProvidedInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
School OperatingfalseSchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Other Employee Paid Over100k0OtherEmployeePaidOver100kCnt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Filed Schedule AYes (true)FiledScheduleAInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1CENTRAL SUFFOLK HOSPITALBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN111661359EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (true)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (true)ListedByNameGoverningDocInd
Suprt Org No IRS DeterminationfalseSuprtOrgNoIRSDeterminationInd
Supported Org Section C456falseSupportedOrgSectionC456Ind
Supported Org Not Organized USfalseSupportedOrgNotOrganizedUSInd
Organization Change Suprt OrgfalseOrganizationChangeSuprtOrgInd
Support Non Supported OrgfalseSupportNonSupportedOrgInd
Payment Substantial ContribtrfalsePaymentSubstantialContribtrInd
Loan Disqualified PersonfalseLoanDisqualifiedPersonInd
Controlled Disqualified PrsnfalseControlledDisqualifiedPrsnInd
Disqualified Prsn Controll IntfalseDisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr IntfalseDisqualifiedPrsnOwnrIntInd
Excess Business Holdings RulesfalseExcessBusinessHoldingsRulesInd
Contribution ControllerfalseContributionControllerInd
Contribution FamilyfalseContributionFamilyInd
Contribution35 ControlledfalseContribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (true)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt OrgfalseOperateBenefitNonSuprtOrgInd

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