2020-05-04T22:56:48-05:00 2019-06-30 272393605 DRISCOLL AND DESIMONE LLC 11 EAGLE DRIVE RINGOES NJ 08551 990 2018-07-01 222095812 UNIVERSITY PHYSICIAN ASSOCIATES OF NEW J UNIV 9739726713 30 BERGEN STREET SUITE 1207 NEWARK NJ 07107 SIMI BAKSHI CFO 9739726713 2020-05-04 1 MICHAEL DRISCOLL P01260803 6097862544 2020-05-04 73.248.104.169 2020-05-04 22:56:44 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 2702CEABEEACC3EBF624D5D3F203BC0E1247C703 2018 2020-09-23 17:36:50Z SIMI BAKSHI 30 BERGEN STREET SUITE 1207 NEWARK NJ 07107 141616286 0 X N/A X 1984 NJ SUPPORTS RUTGERS NEW JERSEY MEDICAL SCHOOL 29 0 47 0 0 0 0 0 131011148 118429291 1007268 1998741 12092504 21188254 144110920 141616286 0 0 0 0 6050334 6336851 0 0 0 130072325 137052911 136122659 143389762 7988261 -1773476 78154146 77664577 48296837 49579665 29857309 28084912 SUPPORTS RUTGERS NEW JERSEY MEDICAL SCHOOL 0 0 104114020 141616286 AMBULATORY AND PRIMARY HEALTH CARE. PROVIDED ASSISTANCE TO CLINICAL FACULTY AT RUTGERS NJ MEDICAL SCHOOL 104114020 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 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 1 1 0 0 0 1 0 0 47 0 0 0 0 0 0 0 0 0 0 0 X 29 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 X SIMI BAKSHI CFO 9739726713 30 BERGEN STREET SUITE 1207 NEWARK NJ 07107 SEENA AISNER MD DIRECTOR 1.00 40.00 X 0 450866 0 CHERYL KENNEDY MD DIRECTOR 1.00 40.00 X 0 321981 0 VLADISLAV BARGMAN MD DIRECTOR 1.00 40.00 X 0 242257 0 JOSEPH BENEVENIA MD DIRECTOR 1.00 40.00 X 0 1167934 0 KRISTIN WONG MD DIRECTOR 1.00 40.00 X 0 305268 0 CHANTAL BRAZEAU MD DIRECTOR 1.00 40.00 X 0 308093 0 MICHAEL CURI MD TREASURER 1.00 40.00 X X 0 1008511 0 LISA DEVER MD DIRECTOR 1.00 40.00 X 0 337107 0 JEAN ANDERSON ELOY MD PRESIDENT 1.00 40.00 X 0 2056142 0 LARRY FROHMAN MD VICE PRESIDENT 1.00 40.00 X X 0 356926 0 LISA GITTENS-WILLIAMS MD DIRECTOR 1.00 40.00 X 0 445144 0 IRA GOLDSTEIN MD DIRECTOR 1.00 40.00 X 0 1488090 0 DENNIS GRECH MD SECRETARY 1.00 40.00 X X 0 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CONLIN-SAWLER HR MANAGER 35.00 X 210188 0 0 VANESSA NOZIGLIA DIRECTOR OF VALUE BASED PE 35.00 X 116535 0 0 NIAZ A KAHN SYSTEM ANALYST I 35.00 X 121190 0 0 MICHAEL SAULICH EX-CEO 35.00 X 343231 0 0 2423267 20163897 0 9 1 1 0 CHANGE HEALTHCARE LLC PO BOX 742526 ATLANTA GA 30374 BILLING & COLLECTION 9534725 NJ PEDIATRIC NEUROSCIENCE INST LLC 131 MADISON AVENUE MORRISTOWN NJ 07960 ON CALL PROVIDER 766312 CHIESA SHAHINIAN & GIANTOMASI ONE BOLAND DRIVE WEST ORANGE NJ 07052 LEGAL SERVICE 701484 IHEALTH SOLUTIONS 500 W JEFFERSON ST LOUISVILLE KY 40202 BILLING & COLLECTION 340904 GOLD ADVISORS LLC 2111 HIDDEN HARBOR DRIVE NEW BERN NC 28562 HEALTHCARE CONSULTING 292200 5 PHYSICIAN BILLING 621110 118156751 118156751 SETTLEMENT REVENUE 621110 272540 272540 118429291 1998741 1998741 MEDICAID SUPPLEMENTAL 621110 18916459 18916459 ELECTRONIC HEALTH REC 621110 1912500 1912500 MARKET CHANGE 621110 359295 359295 21188254 141616286 141616286 0 0 X 2423267 2423267 3113584 3113584 800000 800000 967662 967662 271253 271253 30205422 30205422 35642 35642 125951 125951 595321 595321 565121 565121 39257 39257 133262 133262 DISTRIBUTION TO UPA PHY 52094039 52094039 DISTRIB TO VOLUNTARY GR 28708203 28708203 DISTRIB TO NJMS DEPARTM 11803668 11803668 DISTRIB TO NJMS DEANS F 7994586 7994586 3513524 3513524 143389762 104114020 39275742 0 9879661 4832715 1561657 3131473 5667796 5641113 43586 26683 63693527 54527675 2965797 15138932 9918 7099 78154146 77664577 48296837 49579665 48296837 49579665 X 0 0 0 0 29857309 28084912 29857309 28084912 78154146 77664577 X -1773476 1079 X 0 0 0 X X 1 RUTGERS NJ MEDICAL SCHOOL 226001086 2 1 31896142 0 1 31896142 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 X 5198245 5171562 26683 469551 469551 0 26683 141616286 0 141616286 0 141616286 143389762 0 143389762 0 143389762 X X X 0 0 0 0 0 0 0 0 0 SEENA AISNER MD DIRECTOR 0 450866 0 0 0 0 0 0 0 0 0 450866 0 0 CHERYL KENNEDY MD DIRECTOR 0 321981 0 0 0 0 0 0 0 0 0 321981 0 0 VLADISLAV BARGMAN MD DIRECTOR 0 242257 0 0 0 0 0 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210188 0 0 0 0 0 0 0 0 0 210188 0 0 0 MICHAEL SAULICH EX-CEO 343231 0 0 0 0 0 0 0 0 0 343231 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B COPY OF FORM 990 IS REVIEWED BY THE GOVERNING BODY AFTER IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE DIRECTORS, OFFICERS AND TRUSTEES ARE REQUIRED TO DISCLOSE ANNUAL CONFLICT OF INTEREST IN THEIR POSITIONS WITHIN THE AREAS RELATED TO THEIR ROLE IN DIRECTING POLICY MAKING DECISIONS. IF CONFLICTS ARE DISCOVERED OR DISCLOSED, THEY ARE REVIEWED BY THE EXECUTIVE COMMITTEE AND LEGAL COUNSEL. DICIPLINARY ACTION, IF REQUIRED, IS TAKEN. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS DETERMINE THE COMPENSATION FOR THE CEO AND KEY EMPLOYEES BASED ON BENCHMARKING DATA AND REGIONAL INDUSTRY STANDARD. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G BANK CHARGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 435907. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 435907. TRAINING AND TRAVEL: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 193742. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 193742. BILLING AND COLLECTION SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 8866141. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 8866141. MISCELLANEOUS G&A: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 141057. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 141057. SUPPORT TO RUTGERS: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 1206431. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1206431. SOFTWARE LICENSE FEE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 636055. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 636055. MEDICAID ACCESS TO PHYSICIAN SVC PROGRAM: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 18726089. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 18726089. FORM 990, PART XI, LINE 9: THIS ADJUSTMENT IS THE REVERSAL OF AN ADJUSTMENT MADE ON A PRIOR YEAR 1079. 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