2021-05-12T11:12:30-05:00 2020-06-30 ERNST & YOUNG US LLP 2005 MARKET STREET SUITE 700 PHILADELPHIA PA 19103 990 2019-07-01 461787308 SB Clinical Practice Management Plan Inc % SB CLINICAL PRAC MGMT PLAN I SBCL 6314442055 PO BOX 1554 STONY BROOK NY 11790 MARK TALAMINI MD PRESIDENT & DIRECTOR 6314442055 2021-05-11 true JAMES L ZIESCHE P01264584 2154485336 2019 2022-09-23 18:48:47Z MARK TALAMINI MD PO BOX 1554 STONY BROOK NY 11790 214646064 false X N/A X 2013 NY RESPONSIBLE FOR THE COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 17 0 0 0 0 0 0 0 248756898 214536126 68593 75795 0 0 248825491 214611921 0 0 0 0 105503320 112394390 0 0 0 128831734 120671201 234335054 233065591 14490437 -18453670 135820922 114712208 135820922 114712208 0 0 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 227445872 0 214536126 COLLECTION AND DISBURSEMENT OF MEMBERS' CLINICAL PRACTICE INCOME. 227445872 true false 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 false true true true false false true 95 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 I 6314442055 PO BOX 1554 STONY BROOK NY 11790 RAPHAEL DAVIS MD SECRETARY 1.0 49.0 X X 0 1440088 87941 EVAN JONES MD-MPH DIRECTOR 1.0 49.0 X 0 1146695 73249 MARK TALAMINI MD CHAIRPERSON 1.0 49.0 X X 0 1106244 54727 MARGARET M MCGOVERN MD PHD CHAIRPERSON (THRU 5/1/2018) 1.0 49.0 X 0 977801 104778 WAYNE WALTZER MD DIRECTOR 1.0 49.0 X 0 957721 89179 LAWRENCE HURST DIRECTOR 1.0 49.0 X 0 869238 94177 TONG J GAN VICE CHAIRPERSON 1.0 49.0 X X 0 863587 54321 MARK E SCHWEITZER MD DIRECTOR (Thru 4/28/20) 1.0 49.0 X 0 860043 49560 ROBERT HONKANEN MD DIRECTOR 1.0 49.0 X 0 800976 64703 SAMUEL RYU DIRECTOR 1.0 49.0 X 0 784679 80155 VINCENT W YANG MD PHD DIRECTOR 1.0 49.0 X 0 764234 72272 RAMIN V PARSEY MD PHD DIRECTOR 1.0 49.0 X 0 758258 47456 MARK C HENRY MD DIRECTOR 1.0 49.0 X 0 636242 87461 KENNETH R SHROYER MD PHD DIRECTOR 1.0 49.0 X 0 631015 87994 TODD GRIFFIN MD DIRECTOR 1.0 49.0 X 0 634336 80745 DENNIS CHOI MD PHD DIRECTOR (THRU 6/30/19) 1.0 49.0 X 0 632390 66091 CAROLYN MILANA MD DIRECTOR 1.0 49.0 X 0 469470 73425 ELAINE GOULD Director 1.0 49.0 X 0 475296 63163 PATRICIA COYLE MD DIRECTOR 1.0 49.0 X 0 423307 75186 IRIS A GRANEK MD DIRECTOR 1.0 49.0 X 0 407608 66776 PATRICK SIBONY MD DIRECTOR (THRU 3/28/2018) 1.0 49.0 X 0 374874 68322 CARLOS DE LOS SANTOS DIRECTOR 1.0 49.0 X 0 126737 47409 0 16140839 1589090 0 true true false J BOISEN CONSULTING LLC 12223 HERSHEY BEACH GALVESTON TX 77554 CONSULTING SERVICES 370484 Allen Norin 140 RIVERSIDE DRIVE APT 6D NEW YORK NY 10024 MEDICAL SERVICES 134267 Rasel Rana 8 Fieldhouse Ave SETAUKET NY 11733 MEDICAL SERVICES 135000 3 0 MANAGEMENT FEES 900099 213514347 213514347 RENTAL 531120 1021779 1021779 214536126 20046 20046 0 0 0 0 0 89892 34143 55749 55749 55749 0 0 0 0 0 0 0 0 0 0 214611921 214536126 75795 0 0 0 0 0 0 82567249 78438887 4128362 0 29827141 28335784 1491357 0 0 395130 395130 256097 256097 0 0 12101 12101 40831611 40831611 685233 685233 1805545 1805545 5180060 5180060 0 13435318 13435318 1514815 1514815 0 0 1757650 1757650 0 4693577 4693577 26512426 26512426 MEDICAL EXPENSES 12900600 12900600 CLINICAL PRACTICE RESEARCH 5049369 5049369 DUES AND LICENSE FEES 2059726 2059726 REPAIRS AND MAINTENANCE 3581943 3581943 233065591 227445872 5619719 0 15494262 10904697 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 13380 63651487 30408979 32366577 33242508 4488635 4631328 0 0 0 0 0 0 83471448 65920295 135820922 114712208 7347056 6645523 0 0 0 0 0 0 0 0 0 0 0 0 0 0 128473866 108066685 135820922 114712208 X 0 0 0 0 0 0 135820922 114712208 X -18453670 99045 18354625 X false true X true X X 17 STONY BROOK ANAESTHESIOLOGY UFPC 112553515 10 false 0 0 STONY BROOK CHILDREN'S SERVICE UFPC 112571524 10 false 0 0 STONY BROOK DERMATOLOGY ASSOCIATES UFPC 113011790 10 false 0 0 STONY BROOK EMERGENCY PHYSICIANS UFPC 113066770 10 false 0 0 STONY BROOK FAMILY AND PREVENTIVE MEDICINE UFPC 112552321 10 false 0 0 STONY BROOK INTERNISTS UFPC 112558775 10 false 0 0 NEUROLOGY ASSOCIATES OF STONY BROOK UFPC 112587430 10 false 0 0 NEW YORK SPINE AND BRAIN SURGERY UFPC 112645930 10 false 0 0 UNIVERSITY ASSOCIATES IN OBST & GYNECOLOGY UFPC 112569522 10 false 0 0 STONY BROOK OPHTHALMOLOGY UFPC 112658697 10 false 0 0 STONY BROOK ORTHOPAEDIC ASSOCIATES UFPC 112593061 10 false 0 0 STONY BROOK PATHOLOGISTS UFPC 112647243 10 false 0 0 STONY BROOK PSYCHIATRIC ASSOCIATES UFPC 112590096 10 false 0 0 STONY BROOK RADIATION ONCOLOGY UFPC 112664726 10 false 0 0 STONY BROOK RADIOLOGY UFPC 112548304 10 false 0 0 STONY BROOK SURGICAL ASSOCIATES UFPC 112552333 10 false 0 0 STONY BROOK UROLOGY UFPC 112644371 10 false 0 0 17 0 0 false false false false false false false false false false false false false false false true false Part IV, Section A, line 1: 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. 38574874 10077077 28497797 12970936 10752793 2218143 12105677 9579109 2526568 33242508 ADVANCES TO UFPCS 61351524 ADVANCES - HOSPITAL 68771 INVEST IN NICOLLS INDEMNITY 4500000 65920295 0 CLINICAL PRACTICE RESERVE 89910673 CAPITAL LEASE 18156012 108066685 Central America and the Caribbean Investments Captive Insurance 4500000 4500000 4500000 true false true false false false X false false false false false false false false false MARK TALAMINI MD CHAIRPERSON 0 1028580 0 75271 0 2393 0 39200 0 15527 0 1160971 0 0 TONG J GAN VICE CHAIRPERSON 0 717448 0 143746 0 2393 0 38666 0 15655 0 917908 0 0 RAPHAEL DAVIS MD SECRETARY 0 1307963 0 128429 0 3696 0 70779 0 17162 0 1528029 0 0 EVAN JONES MD-MPH DIRECTOR 0 611430 0 532872 0 2393 0 57402 0 15847 0 1219944 0 0 MARK C HENRY MD DIRECTOR 0 548575 0 85274 0 2393 0 68670 0 18791 0 723703 0 0 IRIS A GRANEK MD DIRECTOR 0 330215 0 75000 0 2393 0 51152 0 15624 0 474384 0 0 VINCENT W YANG MD PHD DIRECTOR 0 675814 0 86027 0 2393 0 56648 0 15624 0 836506 0 0 PATRICIA COYLE MD DIRECTOR 0 367746 0 53168 0 2393 0 57118 0 18068 0 498493 0 0 TODD GRIFFIN MD DIRECTOR 0 556943 0 75000 0 2393 0 65780 0 14965 0 715081 0 0 ROBERT HONKANEN MD DIRECTOR 0 654984 0 143599 0 2393 0 49739 0 14964 0 865679 0 0 KENNETH R SHROYER MD PHD DIRECTOR 0 532533 0 96089 0 2393 0 69421 0 18573 0 719009 0 0 CAROLYN MILANA MD DIRECTOR 0 391543 0 75600 0 2327 0 57446 0 15979 0 542895 0 0 RAMIN V PARSEY MD PHD DIRECTOR 0 665865 0 90000 0 2393 0 32325 0 15131 0 805714 0 0 MARK E SCHWEITZER MD DIRECTOR (Thru 4/28/20) 0 782650 0 75000 0 2393 0 33600 0 15960 0 909603 0 0 SAMUEL RYU DIRECTOR 0 694619 0 87667 0 2393 0 64400 0 15755 0 864834 0 0 WAYNE WALTZER MD DIRECTOR 0 754283 0 201045 0 2393 0 73312 0 15867 0 1046900 0 0 MARGARET M MCGOVERN MD PHD CHAIRPERSON (THRU 5/1/2018) 0 789362 0 185997 0 2442 0 74210 0 30568 0 1082579 0 0 DENNIS CHOI MD PHD DIRECTOR (THRU 6/30/19) 0 479997 0 150000 0 2393 0 49039 0 17052 0 698481 0 0 PATRICK SIBONY MD DIRECTOR (THRU 3/28/2018) 0 330746 0 41735 0 2393 0 52518 0 15804 0 443196 0 0 LAWRENCE HURST DIRECTOR 0 769684 0 96544 0 3010 0 75105 0 19072 0 963415 0 0 CARLOS DE LOS SANTOS DIRECTOR 0 126737 0 0 0 0 0 0 0 47409 0 174146 0 0 ELAINE GOULD Director 0 447156 0 25757 0 2383 0 47880 0 0 0 523176 0 0 FORM 990, PART VI, LINE 11B 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 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 NO DOCUMENTS AVAILABLE TO THE PUBLIC. Form 990, Part XI, Line 9 ALLOCATION TO CLINICAL PRACTICE RESERVE = $18,354,625 LINE 9 TOTAL CHANGE IN NET ASSETS = $18,354,625 FORM 990 PART IX LINE 11G DESCRIPTION:SCHOOL OF MEDICINE CHARGE TOTAL FEES:26405052 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER OPERATING TOTAL FEES:14426559 NEW YORK STATE 1 COMMERCE PLZ 99 WASHINGTON ALBANY NY 12231 146013200 GOVERNMENT NY 501(C)(1) N/A NA 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) N/A CPMP true STONY BROOK SURGICAL HOLDING CORP PO BOX 1554 STONY BROOK NY 11790 116434538 RLTY HOLDING NY 501(C)(25) N/A 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 0 0 false 0 true 1.00000 Nicolls Indemnity Solutions SPC 27 HOSPITAL RD CAYMAN CORP CTR GRAND CAYMAN CJ KY1-9008 981378568 SELF-INSURANCE CJ CPMP C-CORP 12736139 61484594 1.00000 true false false false false false false false false false false true true false false false false true false Stony Brook Surgical Holding Corporation L 340886 Stony Brook CPMP Realty Corporation M 87238