2013-11-14T12:55:48-06:00 2012-12-31 161003516 BROCK SCHECHTER & POLAKOFF LLP 726 EXCHANGE STREET SUITE 822 BUFFALO NY 14210 990 2012-01-01 161485974 UNIVERSITY GYNECOLOGISTS & OBSTETRICIANS UNIV 7168818050 239 BRYANT STREET BUFFALO NY 14222 VANESSA BARNABEI 7168818050 2013-11-14 1 THOMAS P GROGAN P00038022 7168545034 2013-11-14 2012 2016-02-24 21:20:13Z VANESSA BARNABEI 239 BRYANT STREET BUFFALO NY 14222 4039677 0 X WWW.UBOBGYN.COM X 1995 NY THE CORPORATION IS FORMED FOR THE PURPOSE OF SUPPORTING THE EDUCATIONAL PURPOSE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS,INTERNS AND RESIDENTS AND RENDERING PROFESSIONAL SERVICES AND FURTHER TO PRACTICE THE PROFESSION OF MEDICINE. 6 0 36 0 0 0 0 0 1713039 2376875 21017 14731 1441437 1648071 3175493 4039677 0 0 0 0 2586020 3972265 0 0 0 1005769 1493819 3591789 5466084 -416296 -1426407 4125735 3401246 607258 1284224 3518477 2117022 TO PROVIDE THE HIGHEST QUALITY CARE TO WOMEN OF WESTERN NEW YORK IN THE SPECIALTY AREAS OF GENERAL AND HIGH RISK OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE ENDOCRINOLOGY & INFERTILITY. 0 0 4578103 4024946 THE CORPORATION PROVIDED VARIOUS MEDICAL SERVICES TO THE FEMALE POPULATION OF WESTERN NEW YORK SEEKING MEDICAL ATTENTION IN THE AREAS OF OBSTETRICS AND GYNECOLOGY. THE CORPORATION ALSO SUPPORTS THE EDUCATIONAL PURPOSE OF THE STATE UNIVERSITY OF NEW YORK AT BUFFALO SCHOOL OF MEDICINE AND BIOMEDICAL SCIENCES BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS,INTERNS AND RESIDENTS. 4578103 1 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 10 0 1 36 1 0 0 0 0 0 0 0 0 0 0 0 0 X 6 0 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 0 0 1 1 0 NY X X JOHN GARBAY 7168787578 219 BRYANT ST 3RD FLOOR ANNEX BUFFALO NY 14222 ARMANDO ARROYO 40.00 X X 236909 110389 56183 DENNIS MAURICIO 40.00 X X 306233 43762 41549 LATA SANTHAKUMAR 40.00 X X 278747 0 22300 FAYE JUSTICIA-LINDE 40.00 X X 302187 48228 31144 AMOL LELE 40.00 X 241555 118931 26386 WILLIAM DILLON 40.00 X 0 129398 17050 VANESSA BARNABEI 40.00 X X 32281 51984 5201 MANDEEP BRAR 40.00 X 293867 62932 63059 MAJID SHAMAN 40.00 X 311063 46204 32134 CHRISTIAN DOLENSEK 40.00 X 220822 32387 36610 ARMINDA MAURICIO 40.00 X 190327 0 15226 PANKAJ SINGHAL 40.00 X 162500 20867 29937 2576491 665082 376779 11 0 1 0 0 CONTRACT REVENUE 624100 1647350 1647350 FEES FOR SERVICES 624100 729525 729525 2376875 14731 14731 GRADUATE MEDICAL EDUCA 624100 1639344 1639344 MISCELLANEOUS INCOME 624100 8727 8727 1648071 4039677 4024946 0 14731 1507425 1485522 21903 2025812 1899000 126812 154548 123638 30910 218757 175006 43751 65723 52578 13145 2673 2673 102189 102189 17549 17549 12849 12849 101792 35627 66165 210795 34363 176432 35125 35125 3041 3041 113533 113533 28583 28583 MALPRACTICE INSURANCE 338744 338744 0 CONTRACTUAL SERVICES 115098 115098 0 CAO'S FUND 112606 0 112606 CLINICAL SUPPLIES AND F 104433 104433 0 194809 163079 31730 5466084 4578103 887981 0 2742532 1246796 37442 32837 296575 350090 128904 131122 685951 166923 283569 519028 345211 379863 291502 741510 4125735 3401246 342542 671934 264716 227931 0 384359 607258 1284224 X 0 0 0 0 3518477 2117022 3518477 2117022 4125735 3401246 -1426407 24952 0 X X 0 1 X 1 0 X 5594211 5445202 2423183 1713039 2376875 17552510 5594211 5445202 2423183 1713039 2376875 17552510 0 68502 68502 68502 68502 17484008 5378 12135 25346 21741 14731 79331 5378 12135 25346 21741 14731 79331 1028213 1441437 1648071 4117721 5599589 5457337 3476742 3176217 4039677 21749562 0.80390 0.88820 0.00360 0.00600 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12: MISCELLANEOUS INCOME INCLUDES INCOME FROM OTHER HEALTH CARE RELATED ORGANIZATIONS AND PRODUCT SALES THAT ARE RELATED TO THE PRIMARY PURPOSE OF THE ORGANIZATION. GRADUATE MEDICAL REVENUE INCLUDES INCOME FROM AN AFFILIATED ORGANIZATION TO SUPPORT THE MEDICAL STUDENTS. 196159 30690 165469 487842 136152 351690 1950 81 1869 519028 OTHER INVESTMENTS - M&T 379863 F 379863 MALPRACTICE CAPITAL CONTRIBUTIONS 211880 SECURITY DEPOSIT 8145 LONG-TERM PREPAIDS 55289 ELECTRONIC HEALTHCARE SYSTEM ACCESS 466196 741510 DUE TO UBA 384359 384359 X 4064629 24952 24952 4039677 0 4039677 5466084 0 5466084 0 5466084 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE PRACTICE PLAN AND RECOGNIZE A TAX LIABILITY IF THE PRACTICE PLAN HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE INTERNAL REVENUE SERVICE. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE PRACTICE PLAN AND HAS CONCLUDED THAT AS OF DECEMBER 31, 2012, THERE WERE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE PRACTICE PLAN IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. THE PRACTICE PLAN BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2009. X 0 0 0 0 0 0 0 0 0 ARMANDO ARROYO 236909 110389 0 0 0 0 16633 22500 0 17050 253542 149939 0 0 DENNIS MAURICIO 306233 43762 0 0 0 0 24499 0 0 17050 330732 60812 0 0 LATA SANTHAKUMAR 278747 0 0 0 0 0 22300 0 0 0 301047 0 0 0 FAYE JUSTICIA-LINDE 302187 48228 0 0 0 0 24175 0 0 6969 326362 55197 0 0 AMOL LELE 241555 118931 0 0 0 0 19324 0 0 7062 260879 125993 0 0 MANDEEP BRAR 293867 62932 0 0 0 0 23509 22500 0 17050 317376 102482 0 0 MAJID SHAMAN 311063 46204 0 0 0 0 24855 0 0 7279 335918 53483 0 0 CHRISTIAN DOLENSEK 220822 0 0 0 0 32387 17983 0 18627 0 257432 32387 0 0 ARMINDA MAURICIO 190327 0 0 0 0 0 15226 0 0 0 205553 0 0 0 PANKAJ SINGHAL 137500 20867 25000 0 0 0 13000 10390 0 6547 175500 37804 0 0 ARMINDA MAURICIO SPOUSE OF DENNIS MAURICIO 190327 WAGES 0 JOCELYN ARROYO SPOUSE OF ARMANDO ARROYO 21785 WAGES 0 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION DELEGATES CERTAIN MANAGEMENT FUNCTIONS TO A RELATED PARTY, UB ASSOCIATES, INC. IN EXCHANGE FOR A FEE. 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 A, LINE 7B CERTAIN DECISIONS MADE BY THE BOARD OF DIRECTORS ARE SUBJECT TO THE APPROVAL OF MEMBERSHIP AND/OR THE STATE UNIVERSITY OF NEW YORK (SUNY) AT BUFFALO. 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. THIS WAS DONE VIA BOARD MEETING AND EMAIL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES DISCLOSURE OF ANY CONFLICTS OF INTEREST ON AN ANNUAL BASIS. 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. FORM 990, PART XII, LINE 2C THERE HAS BEEN NO CHANGE TO THIS PROCESS SINCE THE PRIOR YEAR. UB ASSOCIATES INC UB DOWNTOWN GATEWAY BUILDING 77 GOO BUFFALO NY 14203 161559460 PROVIDE ADMIN SUPPORT TO SUNY BUFFALO MEDICAL SCHOOL PRACTICE PLAN 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 UB FAMILY MEDICINE INC 77 GOODELL ST BUFFALO NY 14203 161280696 PROVIDES MEDICAL SERVICES NY 501(C)(3) LINE 9 N/A 0 UNIVERSITY AT 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 UNIVERSITY AT BUFFALO PEDIATRIC ASSOCIATES INC 239 BRYANT ST BUFFALO NY 14222 161238821 PROVIDES MEDICAL SERVICES NY 501(C)(3) LINE 9 N/A 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 1 1 0 0 UB ASSOCIATES INC E 410693 MARKET VALUE UB ASSOCIATES INC K 79308 MARKET VALUE UB ASSOCIATES INC P 258052 MARKET VALUE STATE OF NEW YORK E 39833 MARKET VALUE STATE OF NEW YORK P 112606 MARKET VALUE UB FAMILY MEDICINE INC P 64086 MARKET VALUE UNIVERSITY AT BUFFALO PEDIATRIC ASSOCIATES INC D 1625 MARKET VALUE UNIVERSITY AT BUFFALO PEDIATRIC ASSOCIATES INC Q 14625 MARKET VALUE UNIVERSITY AT BUFFALO PEDIATRIC ASSOCIATES INC P 2500 MARKET VALUE UNIVERSITY AT BUFFALO FOUNDATION INC P 44049 MARKET VALUE STATE OF NEW YORK O 819148 MARKET VALUE