2017-07-11T10:59:47-05:00 2016-12-31 161468002 CHIAMPOU TRAVIS BESAW & KERSHNER LLP 45 BRYANT WOODS NORTH AMHERST NY 14228 990 2016-01-01 800033443 UNIVERSITY AT BUFFALO SURGEONS INC UNIV 7168292859 462 GRIDER STREET BUFFALO NY 14215 STEVEN SCHWAITZBERG MD PRESIDENT 7168292859 2017-06-22 1 CHRISTINA BARONE P01360063 7166302400 72.45.217.66 2017-06-22 16:25:40 ED P 4576ECEAE366F3AE1AE44E5EBE13BE5F39CFA2D3 9023691BAC05FE703049B0F9AB7BB703B582E6C7 2016 2021-01-29 14:40:06Z STEVEN SCHWAITZBERG MD 462 GRIDER STREET BUFFALO NY 14215 14936504 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 88 0 0 0 0 0 14491559 14816846 18318 18372 25327 101286 14535204 14936504 0 0 0 0 10676637 11257282 0 0 0 2656088 2985149 13332725 14242431 1202479 694073 9542080 10685738 1914735 2344051 7627345 8341687 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 12420320 14918132 THE CORPORATION PROVIDED MANY VARIED MEDICAL SERVICES TO THE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION FROM SURGEONS. 12420320 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 0 1 0 0 0 1 13 0 88 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 517822 298463 41341 AARON HOFFMAN MD VICE PRESIDENT 40.00 X X 46834 71201 5621 DAVID ROTHSTEIN MD SECRETARY 40.00 X X 0 57885 4631 SUNIL PATEL MD TREASURER 40.00 X X 438585 49334 12977 MACIEJ DRYJSKI MD DIRECTOR 40.00 X 309987 67501 82569 CARROLL HARMON MD PHD DIRECTOR 40.00 X 0 145240 19398 JEFFREY BREWER MD DIRECTOR 40.00 X 475711 42096 71833 WILLIAM FLYNN MD DIRECTOR 40.00 X 365496 74030 84504 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 40.00 X 423943 45496 77182 JAMES MILLS CHIEF FINANCIAL OFFICER 40.00 X 148999 0 18000 WEIDUN ALAN GUO MD SURGEON 40.00 X 411221 49741 75410 JAMES LUKAN MD SURGEON 40.00 X 920522 50991 78568 MICHAEL CHOPKO MD SURGEON 40.00 X 348230 48214 65107 JEFFREY JORDAN MD SURGEON 40.00 X 535574 43966 22094 LIISE KAYLER MD SURGEON 40.00 X 348518 79215 14588 LINDA HARRIS MD FORMER INTERIM DIRECTOR 40.00 X 276950 63730 79439 5568392 1187103 753262 17 1 1 0 0 FEES FOR SERVICE 624100 6974697 6974697 CONTRACT REVENUE 624100 5056771 5056771 GRADUATE MEDICAL EDUCATION REVENU 624100 2414074 2414074 SALARY SUPPORT 624100 195594 195594 MEDICAID SUPPLEMENT 624100 158462 158462 17248 17248 14816846 18372 18372 EMR REFUND 900099 85205 85205 MISCELLANEOUS REVENUE 624100 16081 16081 101286 14936504 14918132 0 18372 3004327 2688994 315333 6518779 5627227 891552 840327 672262 168065 407605 326084 81521 486244 388995 97249 62629 62629 275 220 55 13540 10832 2708 132688 106150 26538 26656 21325 5331 499701 399761 99940 448611 403750 44861 123734 123734 9222 9222 88787 79908 8879 55702 44562 11140 CHIEF ADMINISTRATIVE OF 506443 506443 MALPRACTICE INSURANCE 487945 487945 MEALS AND ENTERTAINMENT 121728 121728 CONTRACTUAL SERVICES 102698 97563 5135 304790 303615 1175 14242431 12420320 1822111 0 6328319 7560050 922466 776271 1099700 1119174 172872 168253 1311121 859321 292221 451800 332775 360547 393727 249643 9542080 10685738 1506511 2017352 408224 326699 1914735 2344051 X 0 0 0 0 7627345 8341687 7627345 8341687 9542080 10685738 694073 20269 0 X 0 1 X 0 0 X 13506397 14824556 13205646 14491559 14816846 70845004 13506397 14824556 13205646 14491559 14816846 70845004 0 1809452 2616130 1346746 1437638 1204589 8414555 1809452 2616130 1346746 1437638 1204589 8414555 62430449 14647 13940 15563 18318 18372 80840 14647 13940 15563 18318 18372 80840 2453708 92170 49277 25327 101286 2721768 15974752 14930666 13270486 14535204 14936504 73647612 0.84770 0.81350 0.00110 0.00110 X SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: MISCELLANEOUS 1311121 859321 451800 451800 14956773 20269 20269 14936504 0 14936504 14242431 0 14242431 0 14242431 X 0 0 0 1 0 1 0 0 0 STEVEN SCHWAITZBERG MD PRESIDENT 517822 282563 0 0 0 15900 0 21200 0 20141 517822 339804 0 0 SUNIL PATEL MD TREASURER 438585 29815 0 0 0 19519 0 4831 0 8146 438585 62311 0 0 MACIEJ DRYJSKI MD DIRECTOR 309987 43501 0 0 0 24000 53000 9428 0 20141 362987 97070 0 0 CARROLL HARMON MD PHD DIRECTOR 0 136456 0 0 0 8784 0 11712 0 7686 0 164638 0 0 JEFFREY BREWER MD DIRECTOR 475711 40551 0 0 0 1545 47571 4121 0 20141 523282 66358 0 0 WILLIAM FLYNN MD DIRECTOR 365496 74030 0 0 0 0 53000 11363 0 20141 418496 105534 0 0 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 423943 25981 0 0 0 19515 53000 4041 0 20141 476943 69678 0 0 JAMES MILLS CHIEF FINANCIAL OFFICER 128999 0 20000 0 0 0 18000 0 0 0 166999 0 0 0 WEIDUN ALAN GUO MD SURGEON 411221 18310 0 0 0 31431 53000 2269 0 20141 464221 72151 0 0 JAMES LUKAN MD SURGEON 920522 32991 0 0 0 18000 53000 7222 0 18346 973522 76559 0 0 MICHAEL CHOPKO MD SURGEON 348230 46729 0 0 0 1485 53000 3961 0 8146 401230 60321 0 0 JEFFREY JORDAN MD SURGEON 535574 42268 0 0 0 1698 0 3880 0 18214 535574 66060 0 0 LIISE KAYLER MD SURGEON 348518 75592 0 0 0 3623 0 6442 0 8146 348518 93803 0 0 LINDA HARRIS MD FORMER INTERIM DIRECTOR 276950 63730 0 0 0 0 52000 9093 0 18346 328950 91169 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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