2018-11-09T08:33:10-06:00 2017-12-31 161468002 CHIAMPOU TRAVIS BESAW & KERSHNER LLP 45 BRYANT WOODS NORTH AMHERST NY 14228 990 2017-01-01 800033443 UNIVERSITY AT BUFFALO SURGEONS INC UNIV 7168292859 462 GRIDER STREET BUFFALO NY 14215 STEVEN SCHWAITZBERG MD PRESIDENT 7168292859 2018-11-08 1 CHRISTINA BARONE P01360063 7166302400 2018-11-08 72.45.217.66 2018-11-08 13:49:02 ES P 83F69475D4E78002AA6035AA2B5DCC541F087679 3CAB4B20C9077208CE704FCC9099C88110051BC5 2017 2019-02-21 02:37:17Z STEVEN SCHWAITZBERG MD 462 GRIDER STREET BUFFALO NY 14215 15290173 0 X WWW.UBMD.COM X 1988 NY 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. 5 0 90 0 0 0 0 109240 14816846 15112492 18372 21848 101286 46593 14936504 15290173 0 0 0 0 11257282 12142153 0 0 0 2985149 2953399 14242431 15095552 694073 194621 10685738 11255512 2344051 2672199 8341687 8583313 X 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. 0 0 13958037 15159085 THE CORPORATION PROVIDED MANY VARIED MEDICAL SERVICES TO THE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION FROM SURGEONS. 13958037 1 1 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 0 1 0 0 0 1 14 0 90 1 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 0 1 1 0 NY X X JAMES MILLS 7168983875 462 GRIDER STREET BUFFALO NY 14215 STEVEN SCHWAITZBERG MD PRESIDENT 40.00 X X 478858 294695 21769 AARON HOFFMAN MD DIRECTOR 40.00 X 49141 73822 0 SUNIL PATEL MD TREASURER 40.00 X X 438565 49292 26673 MACIEJ DRYJSKI MD DIRECTOR 40.00 X 282237 66654 75769 CARROLL HARMON MD PHD DIRECTOR 40.00 X 0 146399 16746 JEFFREY BREWER MD DIRECTOR 40.00 X 488195 40070 70588 WILLIAM FLYNN MD VICE PRESIDENT 40.00 X X 340953 80974 75769 CLAIRICE COOPER MD SECRETARY 40.00 X X 320716 23503 37396 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 40.00 X 368684 44470 75769 JAMES MILLS CHIEF FINANCIAL OFFICER 40.00 X 159290 0 23895 WEIDUN ALAN GUO MD PHYSICIAN 40.00 X 481960 49752 99769 JAMES LUKAN MD PHYSICIAN 40.00 X 806377 51242 73317 WILLIAM TRAIN MD PHYSICIAN 40.00 X 463081 0 0 JEFFREY JORDAN MD PHYSICIAN 40.00 X 710539 42911 19396 ALAN POSNER MD PHYSICIAN 40.00 X 403699 143444 73317 5792295 1107228 690173 19 0 1 0 0 109240 109240 CONTRACT REVENUE 624100 6651704 6651704 FEES FOR SERVICE 624100 5561384 5561384 GRADUATE MEDICAL EDUCATION REVENU 624100 2358929 2358929 SALARY SUPPORT 624100 347708 347708 MEDICAID SUPPLEMENT 624100 156862 156862 35905 35905 15112492 21848 21848 MISCELLANEOUS REVENUE 624100 46593 46593 46593 15290173 15159085 0 21848 2926639 2810168 116471 7395228 6768722 626506 800140 736129 64011 531739 483882 47857 488407 444450 43957 81125 81125 13232 10587 2645 12066 9653 2413 104934 83947 20987 10384 10384 315082 252066 63016 499067 479928 19139 116900 111055 5845 11052 11052 111138 108915 2223 70041 56033 14008 CHIEF ADMINISTRATIVE OF 511355 511355 MALPRACTICE INSURANCE 493465 493465 CONTRACTUAL SERVICES 131160 129848 1312 MEALS AND ENTERTAINMENT 130002 104002 26000 342396 342396 15095552 13958037 1137515 0 7560050 6766255 776271 931478 1119174 2061870 168253 353974 717558 180725 451800 536833 360547 415495 249643 189607 10685738 11255512 2017352 2374345 326699 297854 2344051 2672199 X 0 0 0 0 8341687 8583313 8341687 8583313 10685738 11255512 194621 47005 0 X 0 1 X 0 0 X 109240 109240 14824556 13205646 14491559 14816846 15112492 72451099 14824556 13205646 14491559 14816846 15221732 72560339 0 2616130 1346746 1437638 1204589 913578 7518681 2616130 1346746 1437638 1204589 913578 7518681 65041658 13940 15563 18318 18372 21848 88041 13940 15563 18318 18372 21848 88041 92170 49277 25327 101286 46593 314653 14930666 13270486 14535204 14936504 15290173 72963033 0.89140 0.84770 0.00120 0.00110 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: MISCELLANEOUS 717558 180725 536833 536833 15337178 47005 47005 15290173 0 15290173 15095552 0 15095552 0 15095552 X 0 0 0 1 0 1 0 0 0 STEVEN SCHWAITZBERG MD PRESIDENT 478858 278495 0 0 0 16200 0 0 0 21769 478858 316464 0 0 SUNIL PATEL MD TREASURER 438565 29772 0 0 0 19520 0 18000 0 8673 438565 75965 0 0 MACIEJ DRYJSKI MD DIRECTOR 282237 42654 0 0 0 24000 54000 0 0 21769 336237 88423 0 0 CARROLL HARMON MD PHD DIRECTOR 0 137532 0 0 0 8867 0 0 0 16746 0 163145 0 0 JEFFREY BREWER MD DIRECTOR 488195 38573 0 0 0 1497 48819 0 0 21769 537014 61839 0 0 WILLIAM FLYNN MD VICE PRESIDENT 340953 80974 0 0 0 0 54000 0 0 21769 394953 102743 0 0 CLAIRICE COOPER MD SECRETARY 320716 22589 0 0 0 914 18000 0 0 19396 338716 42899 0 0 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 368684 24973 0 0 0 19497 54000 0 0 21769 422684 66239 0 0 JAMES MILLS CHIEF FINANCIAL OFFICER 159290 0 0 0 0 0 23895 0 0 0 183185 0 0 0 WEIDUN ALAN GUO MD PHYSICIAN 481960 20020 0 0 0 29732 54000 24000 0 21769 535960 95521 0 0 JAMES LUKAN MD PHYSICIAN 806377 33242 0 0 0 18000 54000 0 0 19317 860377 70559 0 0 WILLIAM TRAIN MD PHYSICIAN 463081 0 0 0 0 0 0 0 0 0 463081 0 0 0 JEFFREY JORDAN MD PHYSICIAN 710539 41240 0 0 0 1671 0 0 0 19396 710539 62307 0 0 ALAN POSNER MD PHYSICIAN 403699 143444 0 0 0 0 54000 0 0 19317 457699 162761 0 0 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. 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. 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