2016-05-13T08:30:10-05:00 2015-06-30 221478099 COHNREZNICK LLP 1212 AVENUE OF THE AMERICAS NEW YORK NY 10036 990 2014-07-01 900603487 PHYSICIAN AFFILIATE GROUP OF NEW YORK PC PHYS 6466723651 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 ANTHONY MIRDITA CFO 6466723651 2016-05-13 1 THOMAS LANNING P00851654 2122970400 2014 2016-08-17 19:52:53Z LUIS R MARCOS MD 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 524557863 0 X WWW.PAGNY.ORG X 2010 NY PHYSICIAN AFFILIATE GROUP OF NEW YORK, P.C.(PAGNY)'S MISSION IS TO PROVIDE ACCOUNTABLE, RESPONSIVE, QUALITY CARE WITH THE HIGHEST DEGREE OF SENSITIVITY TO THE NEEDS OF OUR DIVERSE, MULTICULTURAL, MULTILINGUAL POPULATION WHILE FULFILLING THE PROFESSIONAL AND EDUCATIONAL NEEDS OF OUR MEMBERS. 18 0 3089 0 0 0 226588 214743 496958095 524014843 1399 1229 239855 327048 497425937 524557863 10838 13525 0 0 454576616 481995687 0 0 0 43770462 43179120 498357916 525188332 -931979 -630469 1754017 985229 20762988 0 -19008971 985229 X NON-PROFIT "AFFILIATE ORGANIZATION OF PHYSICIANS AND ALLIED HEALTH PROFESSIONALS PROVIDING CLINICAL CARE AND RELATED SUPPORT SERVICES FOR/TO 6 PUBLIC BENEFIT HHC-OWNED CITY HOSPITALS. 1 0 514154436 13525 524341891 PROVIDED PROFESSIONAL MEDICAL SERVICES TO THE METROPOLITAN NEW YORK CITY AREA UNDER AFFILIATION AGREEMENTS WITH NEW YORK CITY HEALTH AND HOSPITALS CORPORATION. 514154436 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 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 1 161 0 1 3089 1 0 0 0 0 0 0 0 0 0 0 X 18 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 NY X ANTHONY MIRDITA 6466723651 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 AKINOLA O FISHER MD TREASURER 40.00 X X 284968 0 55262 ASHOK KHANNA MD DIRECTOR 40.00 X 336571 0 48130 BIJAN SAFAI MD PRESIDENT 26.60 X X 258588 0 33130 JEFFREY GOLDBERG DO DIRECTOR 40.00 X 301652 0 49378 JOHN CLARK MD DIRECTOR 40.00 X 302218 0 39972 LEAQUE AHMED MD DIRECTOR 40.00 X 485267 0 60941 MELBA TAYLOR MD FORMER DIRECTOR 40.00 X 272221 0 33790 MICHELLE STERN MD FORMER DIRECTOR 40.00 X 251909 0 36283 PARDHA VALLURU MD DIRECTOR 40.00 X 249996 0 47298 PAUL MOH MD DIRECTOR 40.00 X 357912 0 33585 PETER KIM MD DIRECTOR 40.00 X 284479 0 53016 RAJESH VERMA MD SECRETARY 40.00 X X 318753 0 23720 RIYAD BASIR MD DIRECTOR 40.00 X 437170 0 55491 ROBERT FAILLACE MD DIRECTOR 40.00 X 339134 0 30034 ROBERT FARRIS MD FORMER DIRECTOR 40.00 X 178650 0 46154 ROGER CHIRURGI MD DIRECTOR 40.00 X 343512 0 26343 SARI KAMINSKY MD DIRECTOR 40.00 X 269411 0 54164 SCOTT ROGGE MD DIRECTOR 30.00 X 302870 0 55069 STEPHEN BLUMBERG MD DIRECTOR 40.00 X 206954 0 54935 WILLIAM B CASPE MD VICE PRESIDENT 40.00 X X 352124 0 56519 YVETTE CALDERON MD DIRECTOR 40.00 X 311918 0 53941 ANTHONY MIRDITA CHIEF FINANCIAL OFFICER 40.00 1.00 X 288097 0 55758 DAVID N HOFFMAN CHIEF COMPLIANCE OFFICER 40.00 X 25782 0 5170 JANE D ZIMMERMAN CHIEF COMMUNICATIONS OFFICER 24.00 X 106880 0 21649 LUIS R MARCOS CHIEF EXECUTIVE OFFICER 40.00 1.00 X 399123 0 53825 REGINALD D ODOM CHIEF HUMAN RESOURCES OFFICER 40.00 X 294713 0 46666 WALTER RAMOS GENERAL COUNSEL 40.00 X 242443 0 54136 ALI SAFAVI DOCTOR 40.00 X 614976 0 48446 AMED RAWANDUZY DOCTOR 40.00 X 608115 0 58888 JOHN MCNELIS DOCTOR 40.00 X 585306 0 60114 MELISSA P SCHORI DOCTOR 40.00 X 586124 0 47701 OLGA BAUMAN-FISHKIN DOCTOR 40.00 X 688011 0 56687 10885847 0 1456195 1374 0 1 0 ORVILLE PALMER LLC 506 LENOX AVENUE ROOM 3132 NEW YORK NY 10037 PHYSICIANS SERVICES 659157 SAMANTHI RAJU MD PLLC 25 WINDY HOLLOW WAY STATEN ISLAND NY 10304 PHYSICIANS SERVICES 289075 LIGHTPATH PARTNERS LLC 89 CHESTNUT HILL ROAD NORTH CALDWELL NJ 07006 PHYSICIANS SERVICES 206304 SABINA OMERHODZIC MD 47-05 CENTER BLVD APT 503 LONG ISLAND CITY NY 11109 PHYSICIANS SERVICES 198250 ROBERT TERZOULI MD 2481 STUART STREET BROOKLYN NY 11229 PHYSICIANS SERVICES 149750 11 214743 214743 NYC HEALTH & HOSPITAL 621110 451087221 451087221 FEE-FOR-SERVICE PLANS 621110 62428985 62428985 SUPPLEMENTAL FEE-FOR S 621110 10452151 10452151 SYMPOSIUM 621110 46486 46486 524014843 1229 1229 AUXILLARY INCOME 621110 327048 327048 327048 524557863 524341891 0 1229 13525 13525 9681128 9507606 173522 378887026 372290082 6596944 24932014 24385495 546519 44334026 43362207 971819 24161493 23631864 529629 57470 57470 172880 172880 37811653 37637469 174184 331338 215951 115387 312767 208119 104648 416407 277082 139325 66243 44080 22163 343286 228427 114859 131630 131630 565196 376088 189108 RECRUITMENT 1167994 777198 390796 ACADEMIC EXPENSES 979229 651591 327638 MEDICAL FEES AND LICENS 519762 345856 173906 REPAIRS AND MAINTANENCE 303265 201796 101469 525188332 514154436 11033896 0 721532 222693 11339 944317 181781 564844 762536 456302 0 1754017 985229 20126039 636949 0 20762988 0 X -19008971 985229 -19008971 985229 1754017 985229 X -630469 20624669 X X 0 1 X 1 0 X 1390168 238117 226588 214743 2069616 93114668 396922833 468803893 496958095 524014843 1979814332 93114668 398313001 469042010 497184683 524229586 1981883948 0 0 0 1981883948 9656 4965 1399 1229 17249 9656 4965 1399 1229 17249 125812 25630 57303 239855 327048 775648 93240480 398348287 469104278 497425937 524557863 1982676845 0.99960 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2012 AMOUNT: $ 42,473. BAD DEBT RECOVERY - 2013 AMOUNT: $ 117,962. REBATES AND REFUNDS - 2013 AMOUNT: $ 15,093. AUXILLARY INCOME - 2011 AMOUNT: $ 25,630. 2012 AMOUNT: $ 14,830. 2013 AMOUNT: $ 6,800. 2014 AMOUNT: $ 327,048. AFFILIATION PAYMENTS - 2010 AMOUNT: $ 125,812. 2013 AMOUNT: $ 100,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 80157 13099 67058 240302 72636 167666 623858 96046 527812 762536 X 524557863 0 524557863 0 524557863 525056702 0 525056702 131630 131630 525188332 PART X, LINE 2: PAGNY HAS NO UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2015 AND 2014. PAGNY'S MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF APPLICABLE, PAGNY WILL RECOGNIZE INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS GENERAL AND ADMINISTRATIVE EXPENSES AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE SPECIAL-PURPOSE STATEMENT OF ASSETS, LIABILITIES AND NET DEFICIT. THERE WERE NO INTEREST OR PENALTIES FOR THE YEARS ENDED JUNE 30, 2015 AND 2014. PART XII, LINE 4B - OTHER ADJUSTMENTS: DEPRECIATION EXPENSE 131,630. X X X X X 1 0 0 0 0 0 0 1 0 AKINOLA O FISHER MD TREASURER 278134 0 6384 0 450 0 25797 0 29465 0 340230 0 0 0 ASHOK KHANNA MD DIRECTOR 332070 0 2521 0 1980 0 24444 0 23686 0 384701 0 0 0 BIJAN SAFAI MD PRESIDENT 232937 0 21918 0 3733 0 22393 0 10737 0 291718 0 0 0 JEFFREY GOLDBERG DO DIRECTOR 297841 0 2521 0 1290 0 24346 0 25032 0 351030 0 0 0 JOHN CLARK MD DIRECTOR 298148 0 2090 0 1980 0 26547 0 13425 0 342190 0 0 0 LEAQUE AHMED MD DIRECTOR 479375 0 5442 0 450 0 32616 0 28325 0 546208 0 0 0 MELBA TAYLOR MD FORMER DIRECTOR 269080 0 2841 0 300 0 21925 0 11865 0 306011 0 0 0 MICHELLE STERN MD FORMER DIRECTOR 249369 0 2090 0 450 0 25000 0 11283 0 288192 0 0 0 PARDHA VALLURU MD DIRECTOR 245495 0 2521 0 1980 0 22838 0 24460 0 297294 0 0 0 PAUL MOH MD DIRECTOR 351528 0 6384 0 0 0 20542 0 13043 0 391497 0 0 0 PETER KIM MD DIRECTOR 281939 0 2090 0 450 0 24039 0 28977 0 337495 0 0 0 RAJESH VERMA MD SECRETARY 318303 0 0 0 450 0 23417 0 303 0 342473 0 0 0 RIYAD BASIR MD DIRECTOR 406430 0 28760 0 1980 0 24486 0 31005 0 492661 0 0 0 ROBERT FAILLACE MD DIRECTOR 337264 0 1045 0 825 0 8769 0 21265 0 369168 0 0 0 ROBERT FARRIS MD FORMER DIRECTOR 171911 0 4082 0 2657 0 17500 0 28654 0 224804 0 0 0 ROGER CHIRURGI MD DIRECTOR 320312 0 22510 0 690 0 24843 0 1500 0 369855 0 0 0 SARI KAMINSKY MD DIRECTOR 243295 0 22306 0 3810 0 23999 0 30165 0 323575 0 0 0 SCOTT ROGGE MD DIRECTOR 296970 0 2090 0 3810 0 25500 0 29569 0 357939 0 0 0 STEPHEN BLUMBERG MD DIRECTOR 204564 0 2090 0 300 0 20975 0 33960 0 261889 0 0 0 WILLIAM B CASPE MD VICE PRESIDENT 343854 0 2090 0 6180 0 25500 0 31019 0 408643 0 0 0 YVETTE CALDERON MD DIRECTOR 309159 0 2069 0 690 0 23384 0 30557 0 365859 0 0 0 ANTHONY MIRDITA CHIEF FINANCIAL OFFICER 267407 0 20000 0 690 0 26173 0 29585 0 343855 0 0 0 LUIS R MARCOS CHIEF EXECUTIVE OFFICER 395390 0 0 0 3733 0 25500 0 28325 0 452948 0 0 0 REGINALD D ODOM CHIEF HUMAN RESOURCES OFFICER 294263 0 0 0 450 0 15587 0 31079 0 341379 0 0 0 WALTER RAMOS GENERAL COUNSEL 230963 0 9500 0 1980 0 23621 0 30515 0 296579 0 0 0 ALI SAFAVI DOCTOR 608894 0 4792 0 1290 0 21081 0 27365 0 663422 0 0 0 AMED RAWANDUZY DOCTOR 598863 0 5442 0 3810 0 31523 0 27365 0 667003 0 0 0 JOHN MCNELIS DOCTOR 578574 0 5442 0 1290 0 30385 0 29729 0 645420 0 0 0 MELISSA P SCHORI DOCTOR 348624 0 0 0 237500 0 19838 0 27863 0 633825 0 0 0 OLGA BAUMAN-FISHKIN DOCTOR 681177 0 6384 0 450 0 25500 0 31187 0 744698 0 0 0 PART I, LINE 4A MELISSA P. SCHORI RECEIVED A SEVERANCE IN FY 15 IN THE AMOUNT OF $237,500. THE AMOUNT AMOUNT IS INCLUDED ON SCHEDULE J, PART II, COLUMN (B)(III). PART I, LINE 7 INCLUDED ON SCHEDULE J, PART II, COLUMN B(II) FOR CERTAIN INDIVIDUALS ARE AMOUNTS REPRESENTING A BONUS. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUAL'S 2014 W-2 AND APPROVED BY THE BOARD. FORM 990, PART III, LINE 2 THE ORGANIZATION ADOPTED THE FOLLOWING NEW MISSION IN FY 15: PHYSICIAN AFFILIATE GROUP OF NEW YORK, P.C.(PAGNY)'S MISSION IS TO PROVIDE ACCOUNTABLE, RESPONSIVE, QUALITY CARE WITH THE HIGHEST DEGREE OF SENSITIVITY TO THE NEEDS OF OUR DIVERSE, MULTICULTURAL, MULTILINGUAL POPULATION WHILE FULFILLING THE PROFESSIONAL AND EDUCATIONAL NEEDS OF OUR MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 THE ORGANIZATION HAS SHAREHOLDERS, WHO MUST MEET THE FOLLOWING QUALIFICATIONS TO BE A SHAREHOLDER, INDIVIDUALLY DULY LICENSED TO PRACTICE MEDICINE IN THE STATE OF NEW YORK, BE A FULL TIME MEMBER OF A MEDICAL STAFF. FORM 990, PART VI, SECTION A, LINE 7A MEMBERS ARE GIVEN ONE VOTE AT THE ANNUAL MEETING TO ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS PREPARED BY A CPA FIRM FROM FINANCIAL STATEMENTS, AS WELL AS, FROM INFORMATION FORM THE ORGANIZATION. THE CPA FIRM FURNISHES A DRAFT FORM 990 WHICH IS REVIEWED BY MANAGEMENT. AFTER APPROVAL, THE FULL BOARD HAS AN OPPORTUNITY TO REVIEW AND COORDINATE ANY APPROPRIATE CHANGES TO FORM 990 BEFORE IT IS FINALIZED AND FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C PAGNY SET UP HOTLINE, EMAIL AND STEEL BOX TO HAVE ALL EMPLOYEES MONITOR AND ENFORCE COMPLIANCE WITH THE POLICY. ANNUALLY THE BOARD MEMBERS MUST SUBMIT DISCLOSURE STATEMENTS THAT ARE REVIEWED BY THE CHIEF COMPLIANCE OFFICER. FORM 990, PART VI, SECTION C, LINE 19 THE DOCUMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: ACCRUAL TO CASH ADJUSTMENT 20,624,669. FORM 990, PART XII, LINE 1: THE ORGANIZATION CHANGED FROM THE ACCRUAL METHOD TO THE CASH METHOD OF ACCOUNTING DURING FY 15. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PREVIOUS YEAR. NEW YORK MEDICAL ALLIANCE UFPC 1400 PELHAM PARKWAY SOUTH BRONX NY 10461 134169311 MEDICAL SERVICES NY 501(C)(3) LINE 9 PHYSICIAN AFFILIATE GROUP OF NEW YORK PC 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 1 0 0