UNIVERSITY AT BUFFALO SURGEONS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY AT BUFFALO SURGEONS INC (EIN 80-0033443)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-27
- IRS object ID
- 202233009349300413
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-27T07:48:36-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161468002 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHIAMPOU TRAVIS BESAW & KERSHNER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 BRYANT WOODS NORTH | AddressLine1Txt |
| City | AMHERST | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800033443 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY AT BUFFALO SURGEONS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 7168292859 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEVEN SCHWAITZBERG MD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7168292859 | PhoneNum |
| Signature | 2022-10-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEVEN | PersonFirstNm |
| Person Last | SCHWAITZBERG MD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EUGENE G KERSHNER | PreparerPersonNm |
| PTIN | P00601324 | PTIN |
| Phone | 7166302400 | PhoneNum |
| Preparation | 2022-10-12 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN SCHWAITZBERG MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,546,953 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UBMD.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | UNIVERSITY AT BUFFALO SURGEONS, INC., IS A LARGE TEAM OF SURGEONS DEDICATED TO THE IMPROVEMENT OF THE HEALTH OF OUR PATIENTS, CUTTING EDGE RESEARCH, AND THE PROFESSIONAL DEVELOPMENT OF OUR STUDENTS AND RESIDENTS. WE ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE TO OUR PATIENTS REQUIRING A SPECIALIST IN GENERAL, VASCULAR AND ENDOVASCULAR, COLORECTAL, MULTI-ORGAN TRANSPLANT, ADVANCED LAPAROSCOPIC, BARIATRIC AND PEDIATRIC SURGERY, AS WELL AS CRITICAL CARE AND BURN MANAGEMENT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 7 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 156 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $394,812 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $25,759,080 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $28,684,457 | CYProgramServiceRevenueAmt |
| PY Investment Income | $91,997 | PYInvestmentIncomeAmt |
| CY Investment Income | $45,074 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,616,926 | PYOtherRevenueAmt |
| CY Other Revenue | $817,422 | CYOtherRevenueAmt |
| PY Total Revenue | $28,862,815 | PYTotalRevenueAmt |
| CY Total Revenue | $29,546,953 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $23,007,026 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,571,130 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,615,140 | PYOtherExpensesAmt |
| CY Other Expenses | $4,431,277 | CYOtherExpensesAmt |
| PY Total Expenses | $26,622,166 | PYTotalExpensesAmt |
| CY Total Expenses | $29,002,407 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,240,649 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $544,546 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,948,834 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,240,216 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,339,013 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,015,535 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,609,821 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,224,681 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | UNIVERSITY AT BUFFALO SURGEONS, INC., IS A LARGE TEAM OF SURGEONS DEDICATED TO THE IMPROVEMENT OF THE HEALTH OF OUR PATIENTS, CUTTING EDGE RESEARCH, AND THE PROFESSIONAL DEVELOPMENT OF OUR STUDENTS AND RESIDENTS. WE ARE COMMITTED TO PROVIDING THE HIGHEST QUALITY CARE TO OUR PATIENTS REQUIRING A SPECIALIST IN GENERAL, VASCULAR AND ENDOVASCULAR, COLORECTAL, MULTI-ORGAN TRANSPLANT, ADVANCED LAPAROSCOPIC, BARIATRIC AND PEDIATRIC SURGERY, AS WELL AS CRITICAL CARE AND BURN MANAGEMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $27,016,207 | ExpenseAmt |
| Revenue | $29,546,331 | RevenueAmt |
| Desc | THE CORPORATION PROVIDED MANY VARIED MEDICAL SERVICES TO THE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION FROM SURGEONS. | Desc |
| Total Program Service Expenses | $27,016,207 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 156 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 7 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES MILLS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7168983875 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| STEVEN SCHWAITZBERG MD | |||||||
| PRESIDENT | 40.00 | Yes (X) | Yes (X) | $402,267 | $0 | $0 | |
| AARON HOFFMAN MD | |||||||
| VICE PRESIDENT | 40.00 | Yes (X) | Yes (X) | $65,544 | $0 | $0 | |
| CARROLL HARMON MD PHD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY BREWER MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $799,172 | $0 | $58,000 | ||
| RAPHAEL BLOCHLE MD | |||||||
| TREASURER | 40.00 | Yes (X) | Yes (X) | $425,573 | $0 | $58,000 | |
| JOSEPH MILLS MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $384,547 | $0 | $0 | ||
| HASAN DOSLUOGLU MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $97,325 | $0 | $0 | ||
| LIISE KAYLER MD | |||||||
| SECRETARY | 40.00 | Yes (X) | Yes (X) | $358,153 | $0 | $0 | |
| YARON PERRY MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $552,478 | $0 | $58,000 | ||
| ALAN POSNER MD | |||||||
| DIRECTOR | 40.00 | Yes (X) | $271,247 | $0 | $54,249 | ||
| AJAY PANCHAL MD | |||||||
| COMPLIANCE OFFICER | 40.00 | Yes (X) | Yes (X) | $619,623 | $0 | $58,000 | |
| JAMES MILLS | |||||||
| CFO | 40.00 | Yes (X) | $215,000 | $0 | $32,250 | ||
| JAMES LUKAN MD | |||||||
| PHYSICIAN | 40.00 | $842,494 | $0 | $55,000 | Yes (X) | ||
| ALAN GUO MD | |||||||
| PHYSICIAN | 40.00 | $835,139 | $0 | $57,997 | Yes (X) | ||
| JEFFREY JORDAN MD | |||||||
| PHYSICIAN | 40.00 | $777,724 | $0 | $0 | Yes (X) | ||
| CLARICE COOPER MD | |||||||
| PHYSICIAN | 40.00 | $715,910 | $0 | $24,000 | Yes (X) | ||
| MICHAEL CHOPKO MD | |||||||
| PHYSICIAN | 40.00 | $645,019 | $0 | $55,000 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $8,007,215 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $510,496 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 42 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAVINOKY COOK LLP | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 726 EXCHANGE STREET SUITE 800 | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14210 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | LEGAL SERVICES | ServicesDesc |
| Compensation | $129,280 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CONTRACT REVENUE | 624100 | $19,054,145 | $19,054,145 |
| FEES FOR SERVICE | 624100 | $4,737,058 | $4,737,058 |
| GRADUATE MEDICAL EDUCATION REVENU | 624100 | $2,839,214 | $2,839,214 |
| SALARY SUPPORT | 624100 | $1,852,446 | $1,852,446 |
| MEDICAID SUPPLEMENT | 624100 | $201,594 | $201,594 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $28,684,457 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,074 | TotalRevenueColumnAmt |
| Exclusion | $45,074 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $817,422 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $817,422 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $817,422 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,546,953 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,501,879 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $45,074 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,190,927 | TotalAmt |
| Program Services | $4,028,649 | ProgramServicesAmt |
| Management And General | $162,278 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,489,065 | TotalAmt |
| Program Services | $16,213,162 | ProgramServicesAmt |
| Management And General | $1,275,903 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,211,704 | TotalAmt |
| Program Services | $1,107,729 | ProgramServicesAmt |
| Management And General | $103,975 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $727,673 | TotalAmt |
| Program Services | $665,232 | ProgramServicesAmt |
| Management And General | $62,441 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $951,761 | TotalAmt |
| Program Services | $870,092 | ProgramServicesAmt |
| Management And General | $81,669 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,935 | TotalAmt |
| Management And General | $75,935 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,897 | TotalAmt |
| Program Services | $112,718 | ProgramServicesAmt |
| Management And General | $28,179 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,499 | TotalAmt |
| Program Services | $25,999 | ProgramServicesAmt |
| Management And General | $6,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $622 | TotalAmt |
| Management And General | $622 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288,538 | TotalAmt |
| Program Services | $230,830 | ProgramServicesAmt |
| Management And General | $57,708 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,060 | TotalAmt |
| Program Services | $59,060 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $312,280 | TotalAmt |
| Program Services | $237,333 | ProgramServicesAmt |
| Management And General | $74,947 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,284 | TotalAmt |
| Program Services | $540,555 | ProgramServicesAmt |
| Management And General | $15,729 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,383 | TotalAmt |
| Program Services | $72,564 | ProgramServicesAmt |
| Management And General | $3,819 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,266 | TotalAmt |
| Program Services | $1,266 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,692 | TotalAmt |
| Program Services | $84,958 | ProgramServicesAmt |
| Management And General | $1,734 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,819 | TotalAmt |
| Program Services | $83,055 | ProgramServicesAmt |
| Management And General | $20,764 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MALPRACTICE INSURANCE | $1,248,023 | $1,248,023 |
| CHIEF ADMINISTRATIVE OF | $905,791 | $905,791 |
| BOOKS, DUES AND SUBSCRI | $134,446 | $134,446 |
| CLINICAL SUPPLIES AND F | $108,301 | $108,301 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300,441 | TotalAmt |
| Program Services | $286,444 | ProgramServicesAmt |
| Management And General | $13,997 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,002,407 | TotalAmt |
| Program Services | $27,016,207 | ProgramServicesAmt |
| Management And General | $1,986,200 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,591,497 | BOYAmt |
| EOY | $7,611,846 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,803,385 | BOYAmt |
| EOY | $2,183,090 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,343,954 | BOYAmt |
| EOY | $4,470,042 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,000 | BOYAmt |
| EOY | $35,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,773 | BOYAmt |
| EOY | $224,598 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $698,258 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $360,211 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,557 | BOYAmt |
| EOY | $338,047 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,984,785 | BOYAmt |
| EOY | $1,716,908 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $817,883 | BOYAmt |
| EOY | $660,685 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,948,834 | BOYAmt |
| EOY | $17,240,216 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,118,430 | BOYAmt |
| EOY | $4,795,476 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,890 | BOYAmt |
| EOY | $10,128 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,693 | BOYAmt |
| EOY | $209,931 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,339,013 | BOYAmt |
| EOY | $5,015,535 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,609,821 | BOYAmt |
| EOY | $12,224,681 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,609,821 | BOYAmt |
| EOY | $12,224,681 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,948,834 | BOYAmt |
| EOY | $17,240,216 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $544,546 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $70,314 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $109,240 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus1 Year | $394,812 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $504,052 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,112,492 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,740,600 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,273,099 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $25,759,080 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,799,223 | CurrentTaxYearAmt |
| Total | $114,684,494 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,221,732 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,740,600 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,273,099 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,153,892 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,799,223 | CurrentTaxYearAmt |
| Total | $115,188,546 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $913,578 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,461,758 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,650,412 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,460,296 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,166,903 | CurrentTaxYearAmt |
| Total | $11,652,947 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $913,578 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,461,758 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,650,412 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,460,296 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,166,903 | CurrentTaxYearAmt |
| Total | $11,652,947 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $103,535,599 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,848 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,580 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,625 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $91,997 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,452 | CurrentTaxYearAmt |
| Total | $330,502 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,848 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,580 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $147,625 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $91,997 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,452 | CurrentTaxYearAmt |
| Total | $330,502 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $46,593 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $87,659 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $852,756 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,616,926 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $817,422 | CurrentTaxYearAmt |
| Total | $4,421,356 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,290,173 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,852,839 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,273,480 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,862,815 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,661,097 | CurrentTaxYearAmt |
| Total | $119,940,404 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.86320 | PublicSupportCY509Pct |
| Public Support PY509 | 0.86980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00280 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00290 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $179,763 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,986 | DepreciationAmt |
| Book Value | $141,777 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $451,653 | OtherCostOrOtherBasisAmt |
| Depreciation | $268,767 | DepreciationAmt |
| Book Value | $182,886 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $66,842 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,458 | DepreciationAmt |
| Book Value | $13,384 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $338,047 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| M&T SECURITIES | $693,928 | F |
| HSBC SECURITIES | $1,022,980 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,716,908 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CHIEF ADMINISTRATIVE OFFICER'S FUND PAYABLE | Desc |
| Amt | $209,931 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $209,931 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $29,616,645 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $70,314 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $70,314 | RevenueNotReportedAmt |
| Revenue Subtotal | $29,546,331 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $622 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $622 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $29,546,953 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $29,001,785 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $29,001,785 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $622 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $622 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $29,002,407 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES LUKAN MD | ||||||||||||||
| PHYSICIAN | $842,494 | $0 | $0 | $0 | $0 | $0 | $55,000 | $0 | $0 | $0 | $897,494 | $0 | $0 | $0 |
| ALAN GUO MD | ||||||||||||||
| PHYSICIAN | $835,139 | $0 | $0 | $0 | $0 | $0 | $57,997 | $0 | $0 | $0 | $893,136 | $0 | $0 | $0 |
| JEFFREY BREWER MD | ||||||||||||||
| DIRECTOR | $799,172 | $0 | $0 | $0 | $0 | $0 | $58,000 | $0 | $0 | $0 | $857,172 | $0 | $0 | $0 |
| JEFFREY JORDAN MD | ||||||||||||||
| PHYSICIAN | $777,724 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $777,724 | $0 | $0 | $0 |
| CLARICE COOPER MD | ||||||||||||||
| PHYSICIAN | $715,910 | $0 | $0 | $0 | $0 | $0 | $24,000 | $0 | $0 | $0 | $739,910 | $0 | $0 | $0 |
| MICHAEL CHOPKO MD | ||||||||||||||
| PHYSICIAN | $645,019 | $0 | $0 | $0 | $0 | $0 | $55,000 | $0 | $0 | $0 | $700,019 | $0 | $0 | $0 |
| AJAY PANCHAL MD | ||||||||||||||
| COMPLIANCE OFFICER | $619,623 | $0 | $0 | $0 | $0 | $0 | $58,000 | $0 | $0 | $0 | $677,623 | $0 | $0 | $0 |
| YARON PERRY MD | ||||||||||||||
| DIRECTOR | $552,478 | $0 | $0 | $0 | $0 | $0 | $58,000 | $0 | $0 | $0 | $610,478 | $0 | $0 | $0 |
| RAPHAEL BLOCHLE MD | ||||||||||||||
| TREASURER | $425,573 | $0 | $0 | $0 | $0 | $0 | $58,000 | $0 | $0 | $0 | $483,573 | $0 | $0 | $0 |
| STEVEN SCHWAITZBERG MD | ||||||||||||||
| PRESIDENT | $402,267 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $402,267 | $0 | $0 | $0 |
| JOSEPH MILLS MD | ||||||||||||||
| DIRECTOR | $384,547 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $384,547 | $0 | $0 | $0 |
| LIISE KAYLER MD | ||||||||||||||
| SECRETARY | $358,153 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $358,153 | $0 | $0 | $0 |
| ALAN POSNER MD | ||||||||||||||
| DIRECTOR | $271,247 | $0 | $0 | $0 | $0 | $0 | $54,249 | $0 | $0 | $0 | $325,496 | $0 | $0 | $0 |
| JAMES MILLS | ||||||||||||||
| CFO | $195,000 | $0 | $20,000 | $0 | $0 | $0 | $32,250 | $0 | $0 | $0 | $247,250 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 5 | SOME OFFICERS, DIRECTORS, KEY EMPLOYEES, OR FIVE HIGHEST PAID EMPLOYEES ARE PHYSICIANS WHOSE INCOME IS PARTIALLY DEPENDENT UPON SERVICES PROVIDED AND THEREFORE DEPENDENT ON THE REVENUE THAT IS DERIVED BY THE ORGANIZATION FROM THESE SERVICES. |
| PART I, LINE 6 | SOME OFFICERS, DIRECTORS, KEY EMPLOYEES, OR FIVE HIGHEST PAID EMPLOYEES ARE PHYSICIANS WHOSE INCOME IS PARTIALLY DEPENDENT UPON SERVICES PROVIDED AND THEREFORE DEPENDENT ON THE REVENUE THAT IS DERIVED BY THE ORGANIZATION FROM THESE SERVICES. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS MEMBERS. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION HAS MEMBERS THAT MAY ELECT OTHER MEMBERS TO THE GOVERNING BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WAS GIVEN TO EACH BOARD MEMBER FOR REVIEW BEFORE THE 990 WAS FILED. THE WAS DONE VIA BOARD MEETING AND EMAIL. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO SIGN AN FPMP EMPLOYMENT AGREEMENT THAT PROHIBITS ANY CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION IS GOVERNED BY ARTICLE XVI OF THE STATE UNIVERSITY OF NEW YORK. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| PART XII, LINE 2C EXPLANATION | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| UB ASSOCIATES INC | ||||||||||
| UB DOWNTOWN GATEWAY BUILDING 77 GOO | BUFFALO | NY | 14203 | 161559460 | PROVIDE ADMINISTRATIVE SUPPORT FOR THE SUNY BUFFALO MEDICAL SCHOOLS | NY | 501(C)(3) | LINE 11 | N/A | 0 |
| STATE OF NEW YORK | ||||||||||
| ONE COMMERCE PLAZA 99 WASHINGTON A | ALBANY | NY | 12231 | 146013200 | GOVERNMENT | NY | 501(C)(1) | N/A | 0 | |
| UNIVERSITY OF BUFFALO FOUNDATION INC | ||||||||||
| PO BOX 900 | BUFFALO | NY | 14226 | 160865182 | PROVIDES SUPPORT FOR AND PROMOTES THE ACTIVITIES OF THE UNIVERSITY | NY | 501(C)(3) | LINE 11 | N/A | 0 |
| UB FAMILY MEDICINE INC | ||||||||||
| 77 GOODELL STREET | BUFFALO | NY | 14203 | 161280696 | PROVIDES MEDICAL SERVICES AND SUPPORTS THE UNIVERSITY EDUCATION | NY | 501(C)(3) | LINE 11 | N/A | 0 |
| ACADEMIC MEDICINE SERVICES INC | ||||||||||
| 4498 MAIN STREET SUITE 23 | AMHERST | NY | 14226 | 161455134 | PROVIDES MEDICAL SERVICES AND SUPPORTS THE UNIVERSITY EDUCATION | NY | 501(C)(3) | LINE 11 | N/A | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| STATE OF NEW YORK | ||
| E | $209,931 | MARKET VALUE |
| STATE OF NEW YORK | ||
| P | $905,791 | MARKET VALUE |