2016-08-09T13:34:51-05:00 2015-12-31 161468002 CHIAMPOU TRAVIS BESAW & KERSHNER LLP 45 BRYANT WOODS NORTH AMHERST NY 14228 990 2015-01-01 800033443 UNIVERSITY AT BUFFALO SURGEONS INC UNIV 7168292859 462 GRIDER STREET BUFFALO NY 14215 STEVEN SCHWAITZBERG MD PRESIDENT 7168292859 2016-08-02 1 DAVID A URBAN P00630018 7166302400 2015 2016-12-15 16:53:06Z STEVEN SCHWAITZBERG MD 462 GRIDER STREET BUFFALO NY 14215 14535204 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 92 0 0 0 0 0 13205646 14491559 15563 18318 49277 25327 13270486 14535204 0 0 0 0 10301344 10676637 0 0 0 2530243 2656088 12831587 13332725 438899 1202479 8762565 9542080 2333501 1914735 6429064 7627345 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 11594526 14516886 THE CORPORATION PROVIDED MANY VARIED MEDICAL SERVICES TO THE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION FROM SURGEONS. 11594526 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 92 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 171657 0 0 MACIEJ DRYJSKI MD VICE PRESIDENT 40.00 X X 296935 64485 80709 PHILIP GLICK MD TREASURER 40.00 X X 32819 156860 37476 CARROLL HARMON MD PHD SECRETARY 40.00 X X 0 137370 30083 JEFFREY BREWER MD DIRECTOR 40.00 X 516689 39988 65881 WILLIAM FLYNN MD DIRECTOR 40.00 X 453048 76276 83365 CHARLES WILES MD DIRECTOR 40.00 X 309958 66555 24585 WEIDUN ALAN GUO MD DIRECTOR 40.00 X 465661 50549 77031 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 40.00 X 562783 43138 75544 JAMES MILLS CHIEF FINANCIAL OFFICER 40.00 X 148899 0 19335 JAMES LUKAN MD SURGEON 40.00 X 731630 48394 77048 MARK LAFTAVI MD SURGEON 40.00 X 327260 53018 79218 ALAN POSNER MD SURGEON 40.00 X 313127 138131 88714 SUNIL PATEL MD SURGEON 40.00 X 308601 48554 11676 MICHAEL CHOPKO MD SURGEON 40.00 X 407350 46557 64516 LINDA HARRIS MD FORMER INTERIM DIRECTOR 40.00 X 231952 61101 77973 5278369 1030976 893154 20 1 1 0 0 FEES FROM SERVICE 624100 7318294 7318294 CONTRACT REVENUE 624100 4552048 4552048 GRADUATE MEDICAL EDUCATION REVENU 624100 2392629 2392629 SALARY SUPPORT 624100 108493 108493 MEDICAID SUPPLEMENT 624100 104415 104415 15680 15680 14491559 18318 18318 MISCELLANEOUS REVENUE 624100 25327 25327 25327 14535204 14516886 0 18318 2958449 2647714 310735 6032036 5192017 840019 834066 667253 166813 431630 345304 86326 420456 336365 84091 49791 49791 44 35 9 16893 13515 3378 107099 85679 21420 6762 5410 1352 510045 408036 102009 430244 387219 43025 127521 127521 6747 6747 74356 66920 7436 67292 53834 13458 CHIEF ADMINISTRATIVE OF 453819 453819 MALPRACTICE INSURANCE 444512 444512 CONTRACTUAL SERVICES 136428 129607 6821 BOOKS, DUES AND SUBSCRI 71704 71704 152831 151315 1516 13332725 11594526 1738199 0 5756362 6328319 771844 922466 1081311 1099700 150627 172872 1290375 998154 131042 292221 329847 332775 541532 393727 8762565 9542080 1985297 1506511 348204 408224 2333501 1914735 X 0 0 0 0 6429064 7627345 6429064 7627345 8762565 9542080 1202479 -4198 0 X 0 1 X 0 0 X 14082377 13506397 14824556 13205646 14491559 70110535 14082377 13506397 14824556 13205646 14491559 70110535 0 1836681 1809452 2616130 1346746 1437638 9046647 1836681 1809452 2616130 1346746 1437638 9046647 61063888 20300 14647 13940 15563 18318 82768 20300 14647 13940 15563 18318 82768 2246990 2453708 92170 49277 25327 4867472 16349667 15974752 14930666 13270486 14535204 75060775 0.81350 0.81010 0.00110 0.00120 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISCELLANEOUS 1290375 998154 292221 292221 14531006 -4198 -4198 14535204 0 14535204 13332725 0 13332725 0 13332725 X 0 0 0 1 0 1 0 0 0 STEVEN SCHWAITZBERG MD PRESIDENT 171657 0 0 0 0 0 0 0 0 0 171657 0 0 0 MACIEJ DRYJSKI MD VICE PRESIDENT 296935 40485 0 0 0 24000 53000 8988 0 18721 349935 92194 0 0 PHILIP GLICK MD TREASURER 32819 122211 0 0 0 34649 6564 23219 0 7693 39383 187772 0 0 CARROLL HARMON MD PHD SECRETARY 0 128849 0 0 0 8521 0 11362 0 18721 0 167453 0 0 JEFFREY BREWER MD DIRECTOR 516689 38517 0 0 0 1471 43237 3923 0 18721 559926 62632 0 0 WILLIAM FLYNN MD DIRECTOR 453048 76276 0 0 0 0 53000 11644 0 18721 506048 106641 0 0 CHARLES WILES MD DIRECTOR 309958 64419 0 0 0 2136 0 5864 0 18721 309958 91140 0 0 WEIDUN ALAN GUO MD DIRECTOR 465661 13906 0 0 0 36643 53000 5310 0 18721 518661 74580 0 0 RAPHAEL BLOCHLE MD COMPLIANCE OFFICER 562783 23704 0 0 0 19434 53000 3823 0 18721 615783 65682 0 0 JAMES MILLS CHIEF FINANCIAL OFFICER 128899 0 20000 0 0 0 19335 0 0 0 168234 0 0 0 JAMES LUKAN MD SURGEON 731630 36727 0 0 0 11667 53000 6848 0 17200 784630 72442 0 0 MARK LAFTAVI MD SURGEON 327260 35018 0 0 0 18000 53000 7497 0 18721 380260 79236 0 0 ALAN POSNER MD SURGEON 313127 138131 0 0 0 0 53000 18514 0 17200 366127 173845 0 0 SUNIL PATEL MD SURGEON 308601 29060 0 0 0 19494 0 3983 0 7693 308601 60230 0 0 MICHAEL CHOPKO MD SURGEON 407350 45123 0 0 0 1434 53000 3823 0 7693 460350 58073 0 0 LINDA HARRIS MD FORMER INTERIM DIRECTOR 231952 61101 0 0 0 0 52000 8773 0 17200 283952 87074 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 11 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. UB ASSOCIATES INC UB DOWNTOWN GATEWAY BUILDING 77 GOO BUFFALO NY 14203 161559460 PROVIDE ADMINISTRATIVE SUPPORT FOR THE SUNY BUFFALO MEDICAL SCHOOLS NY 501(C)(3) LINE 9 N/A 0 STATE OF NEW YORK ONE COMMERCE PLAZA 99 WASHINGTON A ALBANY NY 12231 146013200 GOVERNMENT NY 501(C)(1) N/A 0 UNIVERSITY OF BUFFALO FOUNDATION INC PO BOX 900 BUFFALO NY 14226 160865182 PROVIDES SUPPORT FOR AND PROMOTES THE ACTIVITIES OF THE UNIVERSITY NY 501(C)(3) LINE 9 N/A 0 UB FAMILY MEDICINE INC 77 GOODELL STREET BUFFALO NY 14203 161280696 PROVIDES MEDICAL SERVICES AND SUPPORTS THE UNIVERSITY EDUCATION NY 501(C)(3) LINE 9 N/A 0 ACADEMIC MEDICINE SERVICES INC 4498 MAIN STREET SUITE 23 AMHERST NY 14226 161455134 PROVIDES MEDICAL SERVICES AND SUPPORTS THE UNIVERSITY EDUCATION NY 501(C)(3) LINE 9 N/A 0 0 0 0 1 1 0 0 0 0 0 1 1 0 0 0 1 0 0 0 STATE OF NEW YORK E 40845 MARKET VALUE STATE OF NEW YORK P 453819 MARKET VALUE