2012-11-13T10:24:26-06:00 2011-12-31 161003516 BROCK SCHECHTER & POLAKOFF LLP 726 EXCHANGE STREET SUITE 822 BUFFALO NY 14210 990 2011-01-01 161426208 UNIVERSITY PSYCHIATRIC PRACTICE INC UNIV 7168984535 ERIE COUNTY MEDICAL CENTER 462 GRIDER STREET NO 1168 BUFFALO NY 14215 STEVEN DUBOVSKY 7168984535 2012-11-12 1 THOMAS P GROGAN P00038022 7168545034 2012-11-12 2011 2016-02-24 21:20:13Z ERIE COUNTY MEDICAL CENTER 462 GRIDER STREET BUFFALO NY 14215 12236016 0 X WWW.SMBS.BUFFALO.EDU/PSYCHIATRY X 1992 NY TO ASSIST THE FACULTY OF THE DEPARTMENT OF PSYCHIATRY AT THE UNIVERSITY IN THE DELIVERY OF HEALTH CARE, TO IMPROVE THE ABILITY OF THE FACULTY, TO PERFORM CLINICAL RESEARCH, MAXIMIZE RESOURCES TO FOSTER ACADEMIC, RESEARCH AND CLINICAL PROGRAMS, RECRUIT AND RETAIN TARGETED TEACHING PHYSICIANS AND ENCOURAGE AND SUPPORT THE PERSONAL GROWTH AND PROFESSIONAL DEVELOPMENT OF THE FACULTY OF THE DEPARTMENT OF PSYCHIATRY. 4 0 73 0 0 0 1024507 1299719 9340004 9499091 99468 191926 1022405 593579 11486384 11584315 0 0 0 0 7343692 8057409 0 0 0 2985916 3006129 10329608 11063538 1156776 520777 7343106 7639912 1231476 1073957 6111630 6565955 THE CORPORATION ASSISTS THE STATE UNIVERSITY OF NEW YORK AT BUFFALO DEPARTMENT OF PSYCHIATRY, IN THE DELIVERY OF HEALTH CARE, RECRUITMENT AND RETENTION OF TEACHING PHYSICIANS AND SUPPORT OF RESEARCH IN THE FIELD OF PSYCHIATRY. 0 0 9476784 1299719 10092670 THE CORPORATION ASSISTS THE STATE UNIVERSITY OF NEW YORK AT BUFFALO DEPARTMENT OF PSYCHIATRY, IN THE DELIVERY OF HEALTH CARE, RECRUITMENT AND RETENTION OF TEACHING PHYSICIANS AND SUPPORT OF RESEARCH IN THE FIELD OF PSYCHIATRY. IT DOES THIS THROUGH CLASSROOM AND CLINICAL TEACHING FOR 150 RESIDENTS AND MEDICAL STUDENTS. 9476784 1 1 0 0 0 0 0 0 0 0 1 1 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 0 1 18 0 1 73 1 0 0 0 0 0 0 0 0 0 0 0 0 X 4 0 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 0 1 1 1 0 NY X X PAUL CAVARETTA 7168984535 ECMC462 GRIDER ST BUFFALO NY 14215 S DUBOVSKY MD 40.00 X 259464 255022 71083 SK PARK MD 40.00 X 160093 0 4803 D MARSHALL MD 40.00 X 212753 50141 11884 C WARREN MD 40.00 X 117153 0 3515 J IMPROTA MD 40.00 X 192195 51366 15267 PAUL CAVARETTA 40.00 X 174113 0 17997 Y BAKAHI MD 40.00 X 246053 59587 7382 H YU MD 40.00 X 230547 0 19681 J HAAK MD 40.00 X 157512 0 17499 M CUMMINGS MD 40.00 X 211024 60577 45417 J HOLT MD 40.00 X 202236 0 18841 B NAGRA MD 60.00 X 245863 0 20123 A TAN MD 50.00 X 227039 51151 16609 R LEO MD 40.00 X 224003 60646 6720 V BROOKS MD 40.00 X 179553 45101 11385 A BELTO MD 40.00 X 221752 0 19520 J ANKER MD 40.00 X 224386 55167 38565 N CERVANTES MD 40.00 X 157152 0 17588 D KAYE MD 40.00 X 170427 157596 31882 M GUPPENBERGER MD 45.00 X 191994 0 18533 F QURESHI MD 40.00 X 169820 0 12747 K DOBSON MD 40.00 X 168902 0 17841 S HERNANDEZ MD 40.00 X 157753 0 17505 P DELREGNO MD 28.00 X 123440 53314 14481 B SMITH MD 40.00 X 117412 58086 13060 R WHITNEY MD 40.00 X 111657 0 17192 B MILLER MD 40.00 X 111202 155775 37132 K CHIAPPONE MD 40.00 X 107212 0 15990 5072710 1113529 560242 32 0 1 0 DHAM GUPTA 260 MEADOW VIEW LANE WILLIAMSVILLE NY 14221 PSYCHIATRIC SERVICES 196450 UNIVERSITY OF ROCHESTER 200 CRITTENDEN BLVD ROCHESTER NY 14642 OMH CONTRACT SERVICES AND SUPPORT 146357 2 1299719 1299719 FEES FOR SERVICES 621110 9499091 9499091 9499091 143418 143418 700209 651701 48508 48508 48508 GRADUATE MEDICAL EDUCA 621110 542980 542980 MISCELLANEOUS 621110 50599 50599 593579 11584315 10092670 0 191926 4772502 4309626 462876 2578845 2272424 306421 85113 63835 21278 286895 143448 143447 334054 167027 167027 7122 7122 8110 8110 2155 2155 727 727 22595 5649 16946 72152 50203 21949 184765 166289 18476 24759 24759 51736 7760 43976 CONTRACTUAL SERVICES 2086031 2086031 0 CAO'S FUND 202224 0 202224 MALPRACTICE INSURANCE 87067 87067 0 MEALS & ENTERTAINMENT 56452 47984 8468 200234 68714 131520 11063538 9476784 1586754 0 2974618 3070164 1197837 1288296 200000 0 113179 105789 159549 105912 62055 53637 2761892 3088022 33525 34004 7343106 7639912 1098640 1007316 132836 66641 1231476 1073957 X 0 0 0 0 6111630 6565955 6111630 6565955 7343106 7639912 X 520777 -66452 X X 0 1 1 X 0 X 74130 1024507 1299719 2398356 6217398 7955397 9043592 9340004 9499091 42055482 6217398 8029527 9043592 10364511 10798810 44453838 0 638827 594439 1233266 638827 594439 1233266 43220572 124505 74417 91580 105441 191926 587869 124505 74417 91580 105441 191926 587869 25660 54633 787310 1022405 593579 2483587 6367563 8158577 9922482 11492357 11584315 47525294 0.90940 0.92710 0.01240 0.01140 X SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: SCHEDULE A, PART III, LINE 12, EXPLANATION FOR OTHER INCOME: 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 EDUCATION REVENUE INCLUDES INCOME FROM AN AFFILIATED ORGANIZATION TO SUPPORT THE MEDICAL STUDENTS. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 159549 105912 53637 53637 INVESTMENTS 3088022 F 3088022 11584315 11063538 520777 -66452 -66452 454325 11584315 0 11584315 0 11584315 11063538 0 11063538 0 11063538 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE PRACTICE PLAN HAS ADOPTED ACCOUNTING STANDARDS RELATED TO UNCERTAIN TAX POSITIONS. GENERALLY, THE PRACTICE PLANS PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND MOST OF THE STATES THE PRACTICE PLAN DOES BUSINESS IN. HOWEVER, THE PRACTICE PLAN IS NOT CURRENTLY UNDER AUDIT, NOR HAS THE PRACTICE PLAN BEEN CONTACTED BY ANY OF THESE JURISDICTIONS. X X X X 0 0 0 0 0 0 0 0 0 S DUBOVSKY MD 234464 255022 25000 0 0 0 7784 62573 0 726 267248 318321 0 0 SK PARK MD 145093 0 15000 0 0 0 4803 0 0 0 164896 0 0 0 D MARSHALL MD 202753 50141 10000 0 0 0 6383 5501 0 0 219136 55642 0 0 J IMPROTA MD 177195 51366 15000 0 0 0 5766 5635 0 3866 197961 60867 0 0 PAUL CAVARETTA 154113 0 20000 0 0 0 5250 0 12747 0 192110 0 0 0 Y BAKAHI MD 226053 59587 20000 0 0 0 7382 0 0 0 253435 59587 0 0 H YU MD 220547 0 10000 0 0 0 6934 0 12747 0 250228 0 0 0 J HAAK MD 147512 0 10000 0 0 0 4752 0 12747 0 175011 0 0 0 M CUMMINGS MD 191024 60577 20000 0 0 0 6331 35220 0 3866 217355 99663 0 0 J HOLT MD 202236 0 0 0 0 0 6094 0 12747 0 221077 0 0 0 B NAGRA MD 245863 0 0 0 0 0 7376 0 12747 0 265986 0 0 0 A TAN MD 217039 51151 10000 0 0 0 6811 6632 0 3166 233850 60949 0 0 R LEO MD 219003 60646 5000 0 0 0 6720 0 0 0 230723 60646 0 0 V BROOKS MD 169553 45101 10000 0 0 0 5445 4948 0 992 184998 51041 0 0 A BELTO MD 221752 0 0 0 0 0 6773 0 12747 0 241272 0 0 0 J ANKER MD 216886 55167 7500 0 0 0 6758 28641 0 3166 231144 86974 0 0 N CERVANTES MD 152152 0 5000 0 0 0 4841 0 12747 0 174740 0 0 0 D KAYE MD 145427 157596 25000 0 0 0 5142 23574 0 3166 175569 184336 0 0 M GUPPENBERGER MD 189494 0 2500 0 0 0 5786 0 12747 0 210527 0 0 0 F QURESHI MD 169820 0 0 0 0 0 0 0 12747 0 182567 0 0 0 K DOBSON MD 168902 0 0 0 0 0 5094 0 12747 0 186743 0 0 0 S HERNANDEZ MD 150253 0 7500 0 0 0 4758 0 12747 0 175258 0 0 0 P DELREGNO MD 115940 53314 7500 0 0 0 3703 6912 0 3866 127143 64092 0 0 B SMITH MD 109912 58086 7500 0 0 0 3522 6372 0 3166 120934 67624 0 0 B MILLER MD 101202 155775 10000 0 0 0 3385 30581 0 3166 114587 189522 0 0 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. 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 THE EXECUTIVE COMPENSATION IS GOVERNED BY ARTICLE XVI OF THE STATE UNIVERSITY OF NEW YORK. THE BOARD OF DIRECTORS AND THE PLAN ADMINISTRATOR MEET ANNUALLY TO DETERMINE COMPENSATION. VARIOUS FORMS OF COMPENSATION DATA ARE CONSIDERED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -66,452. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED 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 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 UB ASSOCIATES INC O 35388 MARKET VALUE UB ASSOCIATES INC J 11960 MARKET VALUE STATE OF NEW YORK O 202244 MARKET VALUE STATE OF NEW YORK E 19008 MARKET VALUE