2015-05-14T12:30:14-05:00 2014-06-30 221478099 COHNREZNICK LLP 1212 AVENUE OF THE AMERICAS NEW YORK NY 10036 990 2013-07-01 900603487 PHYSICIAN AFFILIATE GROUP OF NEW YORK PC PHYS 6466723651 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 ANTHONY MIRDITA CFO 6466723651 2015-05-14 1 THOMAS LANNING P00851654 2122970400 2013 2016-03-07 17:11:31Z LUIS R MARCUS MD 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 497425937 0 X WWW.PAGNY.ORG X 2010 NY PAGNY PROVIDES EFFICIENT, ACCOUNTABLE AND RESPONSIVE HEALTHCARE TO THE NEW YORK COMMUNITY THROUGH AFFILIATIONS THAT SERVE THE FINANCIAL, EDUCATIONAL AND ENTREPRENEURIAL NEEDS OF OUR MEMBERS. 18 0 2987 0 0 0 238117 226588 468803893 496958095 4965 1399 57303 239855 469104278 497425937 6603 10838 0 0 426799914 454576616 0 0 0 42421685 43770462 469228202 498357916 -123924 -931979 11328502 1754017 29405494 20762988 -18076992 -19008971 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. 0 0 500516811 10838 497197950 PROVIDED PROFESSIONAL MEDICAL SERVICES TO THE METROPOLITAN NEW YORK CITY AREA UNDER AFFILIATION AGREEMENTS WITH NEW YORK CITY HEALTH AND HOSPITALS CORPORATION. 500516811 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 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 1 125 0 1 2987 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 0 0 0 0 0 0 NY X ANTHONY MIRDITA 7189187259 55 WEST 125TH STREET 10TH FL NEW YORK NY 10027 AKINOLA O FISHER MD TREASURER 40.00 X X 282578 0 39156 ASHOK KHANNA MD DIRECTOR 40.00 X 302284 0 38995 BIJAN SAFAI MD PRESIDENT 26.60 X X 234566 0 26343 DENNIS GREENBAUM MD DIRECTOR 40.00 X 326788 0 48621 DOUGLAS SIMON MD DIRECTOR 40.00 X 248448 0 42439 EDWARD CHEW MD DIRECTOR 40.00 X 254305 0 44150 FERNANDO A JARA MD DIRECTOR 40.00 X 390056 0 44696 JEFFREY GOLDBERG DO DIRECTOR 40.00 X 301226 0 40855 LEAQUE AHMED MD DIRECTOR 40.00 X 664156 0 43387 MELBA TAYLOR MD DIRECTOR 40.00 X 126156 0 9546 MICHELLE STERN MD DIRECTOR 40.00 X 252676 0 33828 PARDHA VALLURU MD DIRECTOR 40.00 X 232371 0 35970 PAUL GENNIS MD DIRECTOR 40.00 X 329654 0 51433 PAUL MOH MD DIRECTOR 40.00 X 407653 0 38255 PETER KIM MD DIRECTOR 40.00 X 280342 0 46724 RAJESH VERMA MD SECRETARY 40.00 X X 304694 0 29057 RIYAD BASIR MD DIRECTOR 40.00 X 450440 0 39829 ROBERT FARRIS MD DIRECTOR 30.00 X 178941 0 40243 ROGER CHIRURGI MD DIRECTOR 40.00 X 300950 0 30000 SARI KAMINSKY MD DIRECTOR 40.00 X 264791 0 43853 SCOTT ROGGE MD DIRECTOR 40.00 X 301610 0 52329 STEPHEN BLUMBERG DIRECTOR 40.00 X 208260 0 46920 WILLIAM B CASPE MD VICE PRESIDENT 40.00 X X 351508 0 53032 ANTHONY MIRDITA CHIEF FINANCIAL OFFICER 40.00 X 141372 0 24377 JANE D ZIMMERMAN CHIEF COMMUNICATION OFFICER 21.00 X 54725 0 8219 LUIS R MARCOS CHIEF EXECUTIVE OFFICER 40.00 X 198299 0 29431 REGINALD D ODOM CHIEF HUMAN RESOURCES OFFICER 40.00 X 101676 0 11000 WALTER RAMOS GENERAL COUNSEL 40.00 X 119395 0 21369 AMED RAWANDUZY MD DOCTOR 40.00 X 699672 0 58499 JOHN MCNELIS DOCTOR 40.00 X 584479 0 58701 LEONARD GOLDEN MD DOCTOR 40.00 X 565054 0 58291 OLGA BAUMAN-FISHKIN DOCTOR 40.00 X 667863 0 49962 SUNIL KHARODE DOCTOR 40.00 X 560432 0 26852 DORIANNE K GLORIA CHIEF HUMAN RESOURCES OFFICER 40.00 X 160114 0 9130 10847534 0 1275492 1312 1 1 0 ORVILLE PALMER 506 LENOX AVENUE ROOM 3132 NEW YORK NY 10037 PHYSICIANS SERVICES 555720 STANLEY KOGAN MD PLLC 613 HALF MOON BAY DRIVE CROTON ON HUDSON NY 10520 PHYSICIANS SERVICES 204996 SABINA OMERHODZIC MD 47-05 CENTER BLVD APT 503 LONG ISLAND CITY NY 11109 PHYSICIANS SERVICES 178425 ROBERT TERZOULI MD 2481 STUART STREET BROOKLYN NY 11229 PHYSICIANS SERVICES 146000 MICHAEL J ALBERTSON MD 360 EAST 65TH STREET NEW YORK NY 10065 PHYSICIANS SERVICES 131250 8 226588 226588 NYC HEALTH & HOSPITAL 621110 419215721 419215721 FEE-FOR-SERVICE PLANS 621110 77697678 77697678 SYMPOSIUM 621110 44696 44696 496958095 1399 1399 BAD DEBT RECOVERY 900099 117962 117962 AFFILIATE REVENUE 900099 100000 100000 REBATES AND REFUNDS 900099 15093 15093 6800 6800 239855 497425937 497197950 0 1399 10838 10838 9112374 8954558 157816 355399182 349257585 6141597 26308639 25810285 498354 41416969 40632946 784023 22339452 21916722 422730 93193 93193 305231 305231 38851794 38583439 268355 465460 330993 134467 184360 131100 53260 342650 243662 98988 79572 56584 22988 1549119 1101593 447526 50152 50152 296363 210746 85617 RECRUITMENT 989079 703343 285736 DATA PROCESSING 269871 191908 77963 LICENSES 82964 58996 23968 OVERHEAD ALLOCATION 0 12174846 -12174846 210654 146667 63987 498357916 500516811 -2158895 0 10162828 1040395 721532 11339 614996 50152 0 564844 125279 456302 11328502 1754017 28601232 20126039 804262 636949 29405494 20762988 X -18076992 -19008971 -18076992 -19008971 11328502 1754017 -931979 0 X X 0 1 X 1 0 X 1390168 238117 226588 1854873 93114668 396922833 468803893 496958095 1455799489 93114668 398313001 469042010 497184683 1457654362 0 0 0 1457654362 9656 4965 1399 16020 9656 4965 1399 16020 125812 25630 57303 239855 448600 93240480 398348287 469104278 497425937 1458118982 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. AFFILIATION PAYMENTS - 2010 AMOUNT: $ 125,812. 2013 AMOUNT: $ 100,000. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 80157 5083 75074 240303 24031 216272 294536 21038 273498 564844 SECURITY DEPOSIT 125280 CONSTRUCTION IN PROGRESS 329322 NYMA DUE TO FROM PAGNY 1000 DUE FROM CI FPP 700 456302 DUE TO DOWNTOWN BRONX MEDICAL ASSOCIATES, PC 636949 636949 X 497425937 0 497425937 0 497425937 498357916 0 498357916 0 498357916 PART X, LINE 2: PAGNY HAS NO UNRECOGNIZED TAX BENEFITS AS OF JUNE 30, 2014 AND 2013. 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, 2014 AND 2013. X X X X X 1 0 0 0 0 0 0 0 0 AKINOLA O FISHER MD TREASURER 282038 0 0 0 540 0 23158 0 15998 0 321734 0 0 0 ASHOK KHANNA MD DIRECTOR 300304 0 0 0 1980 0 26223 0 12772 0 341279 0 0 0 BIJAN SAFAI MD PRESIDENT 230833 0 0 0 3733 0 23781 0 2562 0 260909 0 0 0 DENNIS GREENBAUM MD DIRECTOR 319372 0 0 0 7416 0 27625 0 20996 0 375409 0 0 0 DOUGLAS SIMON MD DIRECTOR 247158 0 0 0 1290 0 24431 0 18008 0 290887 0 0 0 EDWARD CHEW MD DIRECTOR 254035 0 0 0 270 0 21595 0 22555 0 298455 0 0 0 FERNANDO A JARA MD DIRECTOR 389228 0 0 0 828 0 26198 0 18498 0 434752 0 0 0 JEFFREY GOLDBERG DO DIRECTOR 299936 0 0 0 1290 0 27500 0 13355 0 342081 0 0 0 LEAQUE AHMED MD DIRECTOR 663616 0 0 0 540 0 24407 0 18980 0 707543 0 0 0 MICHELLE STERN MD DIRECTOR 252226 0 0 0 450 0 25000 0 8828 0 286504 0 0 0 PARDHA VALLURU MD DIRECTOR 230391 0 0 0 1980 0 22837 0 13133 0 268341 0 0 0 PAUL GENNIS MD DIRECTOR 325844 0 0 0 3810 0 27650 0 23783 0 381087 0 0 0 PAUL MOH MD DIRECTOR 406105 0 0 0 1548 0 29071 0 9184 0 445908 0 0 0 PETER KIM MD DIRECTOR 280042 0 0 0 300 0 24040 0 22684 0 327066 0 0 0 RAJESH VERMA MD SECRETARY 304694 0 0 0 0 0 26121 0 2936 0 333751 0 0 0 RIYAD BASIR MD DIRECTOR 448892 0 0 0 1548 0 21774 0 18055 0 490269 0 0 0 ROBERT FARRIS MD DIRECTOR 171525 0 0 0 7416 0 20653 0 19590 0 219184 0 0 0 ROGER CHIRURGI MD DIRECTOR 300260 0 0 0 690 0 24938 0 5062 0 330950 0 0 0 SARI KAMINSKY MD DIRECTOR 260981 0 0 0 3810 0 23999 0 19854 0 308644 0 0 0 SCOTT ROGGE MD DIRECTOR 297800 0 0 0 3810 0 26646 0 25683 0 353939 0 0 0 STEPHEN BLUMBERG DIRECTOR 208260 0 0 0 0 0 20743 0 26177 0 255180 0 0 0 WILLIAM B CASPE MD VICE PRESIDENT 347698 0 0 0 3810 0 28443 0 24589 0 404540 0 0 0 ANTHONY MIRDITA CHIEF FINANCIAL OFFICER 141280 0 0 0 92 0 13250 0 11127 0 165749 0 0 0 LUIS R MARCOS CHIEF EXECUTIVE OFFICER 197813 0 0 0 486 0 19923 0 9508 0 227730 0 0 0 AMED RAWANDUZY MD DOCTOR 695100 0 0 0 4572 0 39179 0 19320 0 758171 0 0 0 JOHN MCNELIS DOCTOR 583189 0 0 0 1290 0 34639 0 24062 0 643180 0 0 0 LEONARD GOLDEN MD DOCTOR 564364 0 0 0 690 0 32792 0 25499 0 623345 0 0 0 OLGA BAUMAN-FISHKIN DOCTOR 667323 0 0 0 540 0 29287 0 20675 0 717825 0 0 0 SUNIL KHARODE DOCTOR 559142 0 0 0 1290 0 23707 0 3145 0 587284 0 0 0 DORIANNE K GLORIA CHIEF HUMAN RESOURCES OFFICER 109884 0 0 0 50230 0 8158 0 972 0 169244 0 0 0 PART I, LINE 4A DORIANNE K. GLORIA RECEIVED A SEVERANCE PAYMENT IN THE AMOUNT OF 50,000. THIS AMOUNT IS INCLUDED IN PART II, COLUMN B(III). 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. THE ORGANIZATION'S APPLICATION FOR EXEMPT STATUS IS PENDING WITH THE IRS AT THE TIME OF FILING. 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 C, LINE 19 THE DOCUMENTS ARE AVAILABLE BY REQUEST. 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 N/A 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0