2020-08-17T13:23:05-05:00 2019-09-30 050409384 KAHN LITWIN RENZA & CO LTD 951 NORTH MAIN STREET PROVIDENCE RI 02904 990 2018-10-01 821512459 BROWN UROLOGY BROW 4014539623 75 NEWMAN AVENUE 2ND FLOOR RUMFORD RI 02916 MARK SIGMAN MD PRESIDENT 4014539623 2020-08-14 1 SANDY ROSS P01399337 4012742001 71.117.160.66 2020-08-14 11:06:54 ED P 2F85E008C48DD5A141159495B2D1781CA3E157FD D52BEBB77B7FBC4D68F7A8619DEF4FC42F71D885 2018 2020-09-23 17:36:50Z X MARK SIGMAN 75 NEWMAN AVENUE 2ND FLOOR RUMFORD RI 02916 14905532 0 X N/A X 2017 RI THE ORGANIZATION WILL PROVIDE HEALTH CARE SERVICES TO THE GENERAL PUBLIC; SUPPORT THE RESIDENCY PROGRAMS, MEDICAL SCHOOL AND CONTINUING MEDICAL EDUCATINO PROGRAMS FOR STUDENTS OF THE ALPERT MEDICAL SCHOOL AND AT HOSPITALS THAT ARE AFFILIATED WITH THE ALPERT MEDICAL SCHOOL; CONDUCT MEDICAL RESEARCH IN THE AREA OF ADULT AND PEDIATRIC UROLOGY; AND PROVIDE ADMINISTRATIVE SERVICES THE DEPARTMENT OF UROLOGY AT THE ALPERT MEDICAL SCHOOL AND TO UROLOGY DEPARTMENTS AT HOSPITALS WITHIN THE STATE OF RHODE ISLAND THAT ARE AFFILIATED WITH THE ALSPER MEDICAL SCHOOL. 4 0 110 0 0 0 1439722 0 10326263 14819788 0 -73113 369 85744 11766354 14832419 0 0 0 0 6329650 8189688 0 0 0 4974610 6291920 11304260 14481608 462094 350811 2564142 2501844 2102048 1688939 462094 812905 X THE ORGANIZATION WILL PROVIDE HEALTH CARE SERVICES TO THE GENERAL PUBLIC; SUPPORT THE RESIDENCY PROGRAMS, MEDICAL SCHOOL AND CONTINUING MEDICAL EDUCATION PROGRAMS FOR STUDENTS OF THE ALPERT MEDICAL SCHOOL AND AT HOSPITALS THAT ARE AFFILIATED WITH THE ALPERT MEDICAL SCHOOL; CONDUCT MEDICAL RESEARCH IN THE ARAISCONDUCT MEDICAL RESEARCH IN THE AREA OF ADULT AND PEDIATRIC UROLOGY; AND PROVIDE ADMINISTRATIVE SERVICES THE DEPARTMENT OF UROLOGY AT THE ALPERT MEDICAL SCHOOL AND TO UROLOGY DEPARTMENTS AT HOSPITALS WITHIN THE STATE OF RHODE ISLAND THAT ARE AFFILIATED WITH THE ALSPER MEDICAL SCHOOL. 0 0 13862919 14905532 PROVIDE PATIENT MEDICAL CARE, CONTINUTE PROMOTING MEDICAL RESEARCH, EDUCATING THE NEXT GENERATION OF UROLOGIST. 13862919 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 1 18 0 110 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 1 1 X MARK SIGMAN MD 4012762060 827 NORTH MAIN STREET PROVIDENCE RI 02904 MARK SIGMAN MD PRESIDENT 40.00 X X 177774 0 0 GYAN PAREEK MD VICE PRESIDENT 40.00 X X 434685 0 24818 SIMONE THAVASEELAN MD TREASURER 40.00 X X 210644 0 0 STEPHEN SCHIFF MD SECRETARY (UP TO 12/18) 40.00 X X 207836 0 25121 DARGAN GOLIJANIN MD SECRETARY (AS OF 12/18) 40.00 X X 355361 0 17573 LIZA AGUIAR MD PHYSICIAN 40.00 X 235108 0 0 VINCENT HARISARAN MD PHYSICIAN 40.00 X 289295 0 6867 JANICE SANTOS CORTES MD PHYSICIAN 40.00 X 316152 0 9388 ANDREW TOMPKINS MD PHYSICIAN 40.00 X 305401 0 0 2532256 0 83767 9 0 1 0 0 PATIENT FEES 621110 10492375 10492375 ANCILLIARIES 621110 2806268 2806268 RESEARCH 621110 955557 955557 TEACHING 621110 565588 565588 14819788 73113 -73113 -73113 -73113 MISCELLANEOUS 621110 85744 85744 85744 14832419 14905532 0 -73113 X 7259467 6789549 469918 74289 74289 434772 425830 8942 421160 392161 28999 22224 22224 42053 42053 3052067 3046656 5411 32445 32445 147503 109079 38424 188407 188407 1213786 1213786 36157 34735 1422 9485 9485 36856 36856 108713 108713 362446 362446 MEDICAL SUPPLIES 757724 757724 ACADEMIC ASSESSMENT 134598 134598 CONTINUING EDUCATION 47032 47032 SUPPORT AND ASSISTANCE 37195 37195 63229 61933 1296 14481608 13862919 618689 0 279297 382233 1295032 1281636 558292 172410 464607 385882 516070 442957 9136 9136 2564142 2501844 1424054 1148246 152443 63020 525551 477673 2102048 1688939 X 0 0 0 0 462094 812905 462094 812905 2564142 2501844 350811 0 X 0 0 0 X 6835 220 6615 551457 172190 379267 385882 RAIDATION ONCOLOGY 442957 C 442957 X PART X, LINE 2: THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT BELIEVES THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS TAX-EXEMPT STATUS AT BOTH THE STATE AND FEDERAL LEVEL. THE ORGANIZATION HAS BEEN CLASSIFIED AS AN ORGANIZATON THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A)(3). THE ORGANIZATION ANNUALLY FILES IRS FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, REPORTING VARIOUS INFORMATION THAT THE IRS USES TO MONITOR THE ACTIVITIES OF TAX-EXEMPT ENTITIES. THESE TAX RETURNS ARE SUBJECT TO REVIEW BY THE TAXING AUTHORITIES, AND THE FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. THE ORGANIZATION CURRENTLY HAS NO TAX EXAMINATIONS IN PROGRESS. X 1 1 X X X X 0 0 0 0 0 0 0 0 0 MARK SIGMAN MD PRESIDENT 177774 0 0 0 0 0 0 0 0 0 177774 0 0 0 GYAN PAREEK MD VICE PRESIDENT 434685 0 0 0 0 0 0 0 24818 0 459503 0 0 0 SIMONE THAVASEELAN MD TREASURER 210644 0 0 0 0 0 0 0 0 0 210644 0 0 0 STEPHEN SCHIFF MD SECRETARY (UP TO 12/18) 207836 0 0 0 0 0 0 0 25121 0 232957 0 0 0 DARGAN GOLIJANIN MD SECRETARY (AS OF 12/18) 355361 0 0 0 0 0 0 0 17573 0 372934 0 0 0 LIZA AGUIAR MD PHYSICIAN 235108 0 0 0 0 0 0 0 0 0 235108 0 0 0 VINCENT HARISARAN MD PHYSICIAN 289295 0 0 0 0 0 0 0 6867 0 296162 0 0 0 JANICE SANTOS CORTES MD PHYSICIAN 316152 0 0 0 0 0 0 0 9388 0 325540 0 0 0 ANDREW TOMPKINS MD PHYSICIAN 305401 0 0 0 0 0 0 0 0 0 305401 0 0 0 LPR REALTY INVESTMENTS LLC EMPLOYEE OWNED 185700 GYAN PAREEK (VICE PRESIDENT) AND JOSEPH RENZULLI (EMPLOYED PHYSICIAN) EACH OWN A 50% INTEREST IN LPR REALTY INVESTMENTS, LLC, WHICH RENTS MEDICAL OFFICE SPACE TO THE ORGANIZATION 0 FORM 990, PART VI, SECTION A, LINE 2 GYAN PAREEK AND JOSEPH RENZULLI ARE 50 PERCENT PARTNERS EACH IN LPR REALTY INVESTMENTS, LLC WHICH LEASES MEDICAL OFFICE SPACE TO BROWN UROLOGY, INC. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY THE EXTERNAL AUDITORS AND REVIEWED BY MANAGEMENT. ONCE ALL ARE SATISFIED WITH THE FORM, IT IS FINALIZED AND A COPY IS SENT TO ALL BOARD EXECUTIVE COMMITTEE MEMBERS. AT THE SUBSEQUENT BOARD EXECUTIVE COMMITTEE MEETING, THE MEMBERS ARE ASKED IF THEY HAVE ANY QUESTIONS OR COMMENTS AND A GENERAL REVIEW OF THE FORM IS CONDUCTED BY MANAGEMENT. REVISIONS, CORRECTIONS, ETC. ARE MADE AS NECESSARY. SUBSEQUENT TO THIS MEETING THE FORM IS SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY AND DISCUSSED WITH THE PRESIDENT, MEMBERS OF THE BOARD OF TRUSTEES, AND SENIOR MANAGEMENT. THE DOCUMENTATION INCLUDES A DETAILED EXPLANATION OF THE POLICY AND THE ACTIONS TO BE TAKEN IF A CONFLICT SHOULD ARISE. FORM 990, PART VI, SECTION B, LINE 15 BOARD REVIEW. ORGANIATION FOLLOWS THE NATIONAL GUIDELINES SET BY AAMC AND USED BY BROWN PHYSICIANS INC. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS (ARTICLES OF INCORPORATION AND BY-LAWS), ITS CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. THE ORGANIZATION WILL MAIL COPIES UPON REQUEST OR PROVIDE COPIES TO THOSE WHO COME TO THE ADMINISTRATIVE OFFICES DURING NORMAL BUSINESS HOURS. THE ORGANIZATION CHARGES FOR THE COPIES IN ACCORDANCE WITH IRS REGULATIONS. FORM 990, PART IX, LINE 11G OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 288,187. MANAGEMENT AND GENERAL EXPENSES 5,411. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 293,598. BILLING AND COLLECTION SERVICES: PROGRAM SERVICE EXPENSES 258,209. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 258,209. CONTRACTED PHYSICIANS: PROGRAM SERVICE EXPENSES 2,500,260. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,500,260. BROWN PHYSICIANS INC 110 ELM ST 2ND FLOOR PROVIDENCE RI 02903 821858635 SUPPORT AND FURTHER CHARITABLE ACTIVITIES OF ALPERT MEDICAL SCHOOL RI 501(C)(3) 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0