2023-09-13T09:46:36-05:00 2022-12-31 161468002 CHIAMPOU TRAVIS BESAW & KERSHNER LLP 45 BRYANT WOODS NORTH AMHERST NY 14228 990 2022-01-01 161494924 UNIVERSITY EMERGENCY MEDICAL SERVICES INC UNIV 7166459708 77 GOODELL STREET SUITE 340 BUFFALO NY 14203 ROBERT MCCORMACK MD PRESIDENT 7166459708 2023-09-06 1 ROBERT MCCORMACK MD 999009999 0 EUGENE G KERSHNER P00601324 7166302400 2023-09-06 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ROBERT MCCORMACK MD 77 GOODELL STREET SUITE 340 BUFFALO NY 14203 55704932 0 X N/A X 1996 NY TO PROVIDE PRIMARY EMERGENCY CARE MEDICAL SERVICES IN WNY AND CLINICAL INSTRUCTION AND SUPERVISION TO THE STUDENTS OF THE JACOBS SCHOOL OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK AT BUFFALO. 9 0 283 15 0 0 1125198 1309336 53847005 53993444 4356 0 4711235 402152 59687794 55704932 0 0 0 0 48726123 48887869 0 0 0 7674422 8579045 56400545 57466914 3287249 -1761982 15189984 13502775 3668886 3743659 11521098 9759116 TO PROVIDE PRIMARY EMERGENCY CARE MEDICAL SERVICES IN WNY AND CLINICAL INSTRUCTION AND SUPERVISION TO THE STUDENTS OF THE JACOBS SCHOOL OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK AT BUFFALO. 0 0 49669279 53993444 THE CORPORATION PROVIDES EMERGENCY MEDICAL SERVICES TO THE WNY POPULATION. IT EXISTS TO TRAIN MEDICAL STUDENTS, RESIDENTS AND FELLOWS IN THE PRACTICE OF EMERGENCY MEDICINE AND ALSO SUPPORTS THE GENERAL MISSION OF THE JACOBS SCHOOL OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK AT BUFFALO. 49669279 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 18 0 1 283 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 0 1 1 0 NY X JACQUELINE O'LAY 7166459708 77 GOODELL STREET SUITE 340 BUFFALO NY 14203 ROBERT MCCORMACK MD PRESIDENT 40.00 X X 514542 0 39160 GREGORY DIFRANCESCO MD DIRECTOR 40.00 X 537675 0 41400 CHRISTIAN DEFAZIO MD DIRECTOR 40.00 X 362288 0 39160 JENNIFER ROGERS MD SECRETARY 40.00 X X 442599 0 37660 MICHAEL MANKA JR MD DIRECTOR 40.00 X 420675 0 39160 CRISTINE ADAMS MD VICE PRESIDENT 40.00 X X 336120 0 39160 BINDESH PATEL MD DIRECTOR 40.00 X 361919 0 48550 KERRY HLUBIK MD TREASURER 40.00 X X 225531 0 45731 DANIEL FAHEY MD DIRECTOR 40.00 X 498441 0 36600 JACQUELINE O'LAY CFO 40.00 X 172659 0 39087 MICHAEL FILICE MD PHYSICIAN 40.00 X 497720 0 57480 SCOTT BELOTE MD PHYSICIAN 40.00 X 570331 0 56420 NAVEEN SETH MD PHYSICIAN 40.00 X 478987 0 41400 JOHN MCNAMARA MD PHYSICIAN 40.00 X 481274 0 53680 JOSHUA LYNCH MD PHYSICIAN 40.00 X 531349 0 36600 6432110 0 651248 15 0 1 0 PRACTICEFIRST 275 NORTHPOINTE PKWY STE 50 AMHERST NY 14228 BILLING 1218609 LOGIXHEALTH 8 OAK PARK DR BEDFORD MA 01730 CODING 845621 MUSHTAQ KAHN 7121 SALT ROAD CLARENCE NY 14032 PHYSICIAN 408620 GREGORY COLLINS 4820 DARBY ROAD AVON NY 14414 PHYSICIAN 167345 4 692320 617016 1309336 FEE FOR SERVICE 621110 34663174 34663174 CONTRACT REVENUE 621110 16991327 16991327 GRADUATE MEDICAL EDUCATION REVENU 621110 1754954 1754954 MEDICAID SUPPLEMENT 621110 500000 500000 SALARY SUPPORT 621110 83989 83989 53993444 MISCELLANEOUS INCOME 621110 402152 402152 402152 55704932 54395596 0 0 3872449 3432667 439782 37169037 32262274 4906763 4110331 3493782 616549 1685053 1432295 252758 2050999 1743349 307650 197635 197635 600 600 20539 20539 31755 31755 3208 3208 366461 366461 86432 86432 664423 664423 11230 11230 1801982 1633680 168302 CONTRACTUAL SERVICES 2880887 2592798 288089 CAO'S FUND 1827902 1827902 BOOKS DUES AND SUBSCRIP 206660 206660 CONTRIBUTION EXPENSE 154640 139176 15464 324691 237065 87626 57466914 49669279 7797635 0 8207362 4983248 6372628 7897105 255243 278626 254576 136693 129113 117883 225638 225913 15189984 13502775 3328671 3593877 2500 2500 337715 147282 3668886 3743659 X 11521098 9759116 11521098 9759116 15189984 13502775 -1761982 0 X X 0 1 X 1 0 X 632630 641474 1497842 1125198 1309336 5206480 43189670 47909922 48600860 53847005 53993444 247540901 43822300 48551396 50098702 54972203 55302780 252747381 0 1269632 1840890 332811 2603136 2504103 8550572 1269632 1840890 332811 2603136 2504103 8550572 244196809 9781 66554 28674 4356 109365 9781 66554 28674 4356 109365 385703 462547 279626 451705 402152 1981733 44217784 49080497 50407002 55428264 55704932 254838479 0.95820 0.96070 0.00040 0.00050 X LINE 12 EXPLANATION MISCELLANEOUS INCOME INCLUDES INCOME FROM OTHER HEALTH CARE RELATED ORGANIZATIONS AND PRODUCT SALES THAT ARE RELATED TO THE PRIMARY PURPOSE OF THE ORGANIZATION. 165549 47729 117820 50234 50234 0 38793 38730 63 117883 CHIEF ADMINISTRATIVE OFFICER'S FUND PAYABLE 147282 147282 55704932 0 55704932 0 55704932 57466914 0 57466914 0 57466914 X 0 0 0 0 0 0 0 0 0 SCOTT BELOTE MD PHYSICIAN 488240 0 82091 0 0 0 36600 0 19820 0 626751 0 0 0 GREGORY DIFRANCESCO MD DIRECTOR 415624 0 122051 0 0 0 36600 0 4800 0 579075 0 0 0 JOSHUA LYNCH MD PHYSICIAN 448738 0 82611 0 0 0 36600 0 0 0 567949 0 0 0 MICHAEL FILICE MD PHYSICIAN 418845 0 78875 0 0 0 36600 0 20880 0 555200 0 0 0 ROBERT MCCORMACK MD PRESIDENT 406542 0 108000 0 0 0 36600 0 2560 0 553702 0 0 0 DANIEL FAHEY MD DIRECTOR 416390 0 82051 0 0 0 36600 0 0 0 535041 0 0 0 JOHN MCNAMARA MD PHYSICIAN 399223 0 82051 0 0 0 36600 0 17080 0 534954 0 0 0 NAVEEN SETH MD PHYSICIAN 420462 0 58525 0 0 0 36600 0 4800 0 520387 0 0 0 JENNIFER ROGERS MD SECRETARY 360548 0 82051 0 0 0 36600 0 1060 0 480259 0 0 0 MICHAEL MANKA JR MD DIRECTOR 332675 0 88000 0 0 0 36600 0 2560 0 459835 0 0 0 BINDESH PATEL MD DIRECTOR 323919 0 38000 0 0 0 36600 0 11950 0 410469 0 0 0 CHRISTIAN DEFAZIO MD DIRECTOR 289288 0 73000 0 0 0 36600 0 2560 0 401448 0 0 0 CRISTINE ADAMS MD VICE PRESIDENT 298120 0 38000 0 0 0 36600 0 2560 0 375280 0 0 0 KERRY HLUBIK MD TREASURER 198031 0 27500 0 0 0 27971 0 17760 0 271262 0 0 0 JACQUELINE O'LAY CFO 142659 0 30000 0 0 0 21327 0 17760 0 211746 0 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 A, LINE 7B CERTAIN DECISIONS MADE BY THE GOVERNING BODY ARE SUBJECT TO RATIFICATION BY MEMBERS. FORM 990, PART VI, SECTION B, LINE 11B 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 DIRECTORS ARE COVERED UNDER THE CONFLICT OF INTEREST POLICY WHICH IS MONITORED ON AN ONGOING BASIS BY THE DEPARTMENT ADMINISTRATION. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION IS GOVERNED BY ARTICLE XVI OF THE STATE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. 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