UNIVERSITY AT BUFFALO SURGEONS INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- UNIVERSITY AT BUFFALO SURGEONS INC (EIN 80-0033443)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-11-16
- IRS object ID
- 201543209349306594
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-11-16T12:19:47-06:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161468002 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHIAMPOU TRAVIS BESAW & KERSHNER LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 45 BRYANT WOODS NORTH | AddressLine1Txt |
| City | AMHERST | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14228 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 800033443 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UNIVERSITY AT BUFFALO SURGEONS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | UNIV | BusinessNameControlTxt |
| Phone | 7168292859 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM FLYNN JR MD | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7168292859 | PhoneNum |
| Signature | 2015-11-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID A URBAN | PreparerPersonNm |
| PTIN | P00630018 | PTIN |
| Phone | 7166302400 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-04-25 22:37:26Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | WILLIAM FLYNN JR MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,270,486 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.UBMD.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | 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. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 92 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,824,556 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,205,646 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,940 | PYInvestmentIncomeAmt |
| CY Investment Income | $15,563 | CYInvestmentIncomeAmt |
| PY Other Revenue | $92,170 | PYOtherRevenueAmt |
| CY Other Revenue | $49,277 | CYOtherRevenueAmt |
| PY Total Revenue | $14,930,666 | PYTotalRevenueAmt |
| CY Total Revenue | $13,270,486 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,951,625 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,301,344 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,686,692 | PYOtherExpensesAmt |
| CY Other Expenses | $2,530,243 | CYOtherExpensesAmt |
| PY Total Expenses | $13,638,317 | PYTotalExpensesAmt |
| CY Total Expenses | $12,831,587 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,292,349 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $438,899 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,908,029 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,762,565 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,942,308 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,333,501 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,965,721 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,429,064 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | 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. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,141,760 | ExpenseAmt |
| Revenue | $13,254,923 | RevenueAmt |
| Desc | THE CORPORATION PROVIDED MANY VARIED MEDICAL SERVICES TO THE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION FROM SURGEONS. | Desc |
| Total Program Service Expenses | $11,141,760 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 92 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JAMES MILLS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7168983875 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 462 GRIDER STREET | AddressLine1Txt |
| City | BUFFALO | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| JEFFREY BREWER MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $469,905 | $36,828 | $21,669 | |||
| RAPHAEL BLOCHLE MD | ||||||||
| COMPLIANCE OFFICER | 40.00 | Yes (X) | $441,716 | $41,228 | $73,669 | Yes (X) | ||
| WILLIAM FLYNN MD | ||||||||
| INTERIM PRESIDENT/DIRECTOR | 40.00 | Yes (X) | $354,589 | $101,675 | $85,475 | |||
| MACIEJ DRYJSKI MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $342,741 | $62,018 | $78,681 | |||
| LINDA HARRIS MD | ||||||||
| TEMPORARY DIRECTOR/SECRETARY | 40.00 | Yes (X) | $267,068 | $54,108 | $78,374 | Yes (X) | ||
| CHARLES WILES MD | ||||||||
| VICE PRESIDENT | 40.00 | Yes (X) | $238,290 | $65,035 | $23,574 | |||
| WEIDUN ALAN GUO MD | ||||||||
| TREASURER | 40.00 | Yes (X) | $326,009 | $45,892 | $75,099 | |||
| JAMES MILLS | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $147,909 | $0 | $0 | Yes (X) | |||
| JAMES LUKAN MD | ||||||||
| SURGEON | 40.00 | $641,082 | $45,488 | $73,416 | Yes (X) | |||
| MARK LAFTAVI MD | ||||||||
| SURGEON | 40.00 | $324,918 | $50,851 | $77,230 | Yes (X) | |||
| ALAN POSNER MD | ||||||||
| SURGEON | 40.00 | $303,827 | $132,885 | $88,290 | Yes (X) | |||
| SUNIL PATEL MD | ||||||||
| SURGEON | 40.00 | $299,913 | $47,157 | $11,285 | Yes (X) | |||
| GREGORY CHERR MD | ||||||||
| SURGEON | 40.00 | $278,333 | $81,939 | $44,009 | Yes (X) | |||
| PHILIP GLICK MD | ||||||||
| FORMER OFFICER | 40.00 | $36,698 | $146,975 | $36,501 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,472,998 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $912,079 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $767,272 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| FEES FROM SERVICE | 624100 | $6,833,705 | $6,833,705 |
| CONTRACT REVENUE | 624100 | $3,656,095 | $3,656,095 |
| GRADUATE MEDICAL EDUCATION REVENU | 624100 | $2,221,690 | $2,221,690 |
| SALARY SUPPORT | 624100 | $381,802 | $381,802 |
| MEDICAID SUPPLEMENT | 624100 | $65,314 | $65,314 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $47,040 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $47,040 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,205,646 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,563 | TotalRevenueColumnAmt |
| Exclusion | $15,563 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $49,277 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $49,277 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $49,277 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,270,486 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,254,923 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $15,563 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,624,925 | TotalAmt |
| Program Services | $2,114,731 | ProgramServicesAmt |
| Management And General | $510,194 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,825,408 | TotalAmt |
| Program Services | $5,241,019 | ProgramServicesAmt |
| Management And General | $584,389 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $977,386 | TotalAmt |
| Program Services | $781,909 | ProgramServicesAmt |
| Management And General | $195,477 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,180 | TotalAmt |
| Program Services | $323,273 | ProgramServicesAmt |
| Management And General | $93,907 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $456,445 | TotalAmt |
| Program Services | $375,627 | ProgramServicesAmt |
| Management And General | $80,818 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,107 | TotalAmt |
| Management And General | $29,107 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $480 | TotalAmt |
| Program Services | $384 | ProgramServicesAmt |
| Management And General | $96 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,906 | TotalAmt |
| Program Services | $26,325 | ProgramServicesAmt |
| Management And General | $6,581 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,121 | TotalAmt |
| Program Services | $109,697 | ProgramServicesAmt |
| Management And General | $27,424 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,160 | TotalAmt |
| Program Services | $4,128 | ProgramServicesAmt |
| Management And General | $1,032 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $414,404 | TotalAmt |
| Program Services | $331,523 | ProgramServicesAmt |
| Management And General | $82,881 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $477,784 | TotalAmt |
| Program Services | $430,006 | ProgramServicesAmt |
| Management And General | $47,778 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,484 | TotalAmt |
| Program Services | $118,484 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10 | TotalAmt |
| Program Services | $10 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,903 | TotalAmt |
| Program Services | $53,013 | ProgramServicesAmt |
| Management And General | $5,890 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,585 | TotalAmt |
| Program Services | $56,468 | ProgramServicesAmt |
| Management And General | $14,117 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MALPRACTICE INSURANCE | $398,592 | $398,592 | |
| CAO'S FUND | $378,509 | $378,509 | |
| CONTRACTUAL SERVICES | $178,002 | $169,102 | $8,900 |
| BOOKS, DUES AND SUBSCRI | $98,018 | $98,018 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,178 | TotalAmt |
| Program Services | $130,942 | ProgramServicesAmt |
| Management And General | $1,236 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,831,587 | TotalAmt |
| Program Services | $11,141,760 | ProgramServicesAmt |
| Management And General | $1,689,827 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,980,868 | BOYAmt |
| EOY | $5,756,362 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $841,349 | BOYAmt |
| EOY | $771,844 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,666 | BOYAmt |
| EOY | $1,081,311 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,037 | BOYAmt |
| EOY | $150,627 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,054,840 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $923,798 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $163,933 | BOYAmt |
| EOY | $131,042 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $298,560 | BOYAmt |
| EOY | $329,847 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $685,616 | BOYAmt |
| EOY | $541,532 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,908,029 | BOYAmt |
| EOY | $8,762,565 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,446,334 | BOYAmt |
| EOY | $1,985,297 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $495,974 | BOYAmt |
| EOY | $348,204 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,942,308 | BOYAmt |
| EOY | $2,333,501 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,965,721 | BOYAmt |
| EOY | $6,429,064 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,965,721 | BOYAmt |
| EOY | $6,429,064 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,908,029 | BOYAmt |
| EOY | $8,762,565 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $438,899 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $24,444 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,428,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,082,377 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,506,397 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,824,556 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,205,646 | CurrentTaxYearAmt |
| Total | $71,047,354 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,428,378 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,082,377 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,506,397 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,824,556 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,205,646 | CurrentTaxYearAmt |
| Total | $71,047,354 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,791,287 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,836,681 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,809,452 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,616,130 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,346,746 | CurrentTaxYearAmt |
| Total | $9,400,296 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,791,287 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,836,681 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,809,452 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,616,130 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,346,746 | CurrentTaxYearAmt |
| Total | $9,400,296 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $61,647,058 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,300 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,647 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,940 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,563 | CurrentTaxYearAmt |
| Total | $90,054 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,604 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,300 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,647 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,940 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,563 | CurrentTaxYearAmt |
| Total | $90,054 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $116,033 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,246,990 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,453,708 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $92,170 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $49,277 | CurrentTaxYearAmt |
| Total | $4,958,178 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,570,015 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,349,667 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,974,752 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,930,666 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,270,486 | CurrentTaxYearAmt |
| Total | $76,095,586 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.81010 | PublicSupportCY509Pct |
| Public Support PY509 | 0.83050 | PublicSupportPY509Pct |
| Investment Income CY | 0.00120 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00140 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,054,840 | OtherCostOrOtherBasisAmt |
| Depreciation | $923,798 | DepreciationAmt |
| Book Value | $131,042 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $131,042 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| MALPRACTICE CAPITAL CONTRIBUTIONS | $185,827 |
| INVESTMENT IN PARTNERSHIP | $3,801 |
| DEPOSITS | $3,700 |
| ELECTRONIC HEALTHCARE SYSTEM ACCESS | $348,204 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $541,532 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $13,294,930 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $24,444 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $24,444 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,270,486 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,270,486 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,831,587 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,831,587 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,831,587 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (1) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (1) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEFFREY BREWER MD | ||||||||||||||
| DIRECTOR | $469,905 | $35,442 | $0 | $0 | $0 | $1,386 | $0 | $3,695 | $0 | $17,974 | $469,905 | $58,497 | $0 | $0 |
| RAPHAEL BLOCHLE MD | ||||||||||||||
| COMPLIANCE OFFICER | $441,716 | $22,342 | $0 | $0 | $0 | $18,886 | $52,000 | $3,695 | $0 | $17,974 | $493,716 | $62,897 | $0 | $0 |
| WILLIAM FLYNN MD | ||||||||||||||
| INTERIM PRESIDENT/DIRECTOR | $354,589 | $101,675 | $0 | $0 | $0 | $0 | $52,000 | $15,501 | $0 | $17,974 | $406,589 | $135,150 | $0 | $0 |
| MACIEJ DRYJSKI MD | ||||||||||||||
| DIRECTOR | $342,741 | $44,518 | $0 | $0 | $0 | $17,500 | $52,000 | $8,707 | $0 | $17,974 | $394,741 | $88,699 | $0 | $0 |
| LINDA HARRIS MD | ||||||||||||||
| TEMPORARY DIRECTOR/SECRETARY | $267,068 | $54,108 | $0 | $0 | $0 | $0 | $52,000 | $8,069 | $0 | $18,305 | $319,068 | $80,482 | $0 | $0 |
| CHARLES WILES MD | ||||||||||||||
| VICE PRESIDENT | $238,290 | $62,935 | $0 | $0 | $0 | $2,100 | $0 | $5,600 | $0 | $17,974 | $238,290 | $88,609 | $0 | $0 |
| WEIDUN ALAN GUO MD | ||||||||||||||
| TREASURER | $326,009 | $15,843 | $0 | $0 | $0 | $30,049 | $52,000 | $5,125 | $0 | $17,974 | $378,009 | $68,991 | $0 | $0 |
| JAMES LUKAN MD | ||||||||||||||
| SURGEON | $641,082 | $44,677 | $0 | $0 | $0 | $811 | $52,000 | $3,111 | $0 | $18,305 | $693,082 | $66,904 | $0 | $0 |
| MARK LAFTAVI MD | ||||||||||||||
| SURGEON | $324,918 | $33,351 | $0 | $0 | $0 | $17,500 | $52,000 | $7,256 | $0 | $17,974 | $376,918 | $76,081 | $0 | $0 |
| ALAN POSNER MD | ||||||||||||||
| SURGEON | $303,827 | $132,885 | $0 | $0 | $0 | $0 | $52,000 | $17,985 | $0 | $18,305 | $355,827 | $169,175 | $0 | $0 |
| SUNIL PATEL MD | ||||||||||||||
| SURGEON | $299,913 | $28,201 | $0 | $0 | $0 | $18,956 | $0 | $3,884 | $0 | $7,401 | $299,913 | $58,442 | $0 | $0 |
| GREGORY CHERR MD | ||||||||||||||
| SURGEON | $278,333 | $81,939 | $0 | $0 | $0 | $0 | $14,342 | $11,362 | $0 | $18,305 | $292,675 | $111,606 | $0 | $0 |
| PHILIP GLICK MD | ||||||||||||||
| FORMER OFFICER | $36,698 | $100,975 | $0 | $0 | $0 | $46,000 | $7,340 | $21,760 | $0 | $7,401 | $44,038 | $176,136 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| STATE OF NEW YORK | ||
| E | $161,693 | MARKET VALUE |
| STATE OF NEW YORK | ||
| P | $378,509 | MARKET VALUE |