2023-10-31T07:08:11-05:00 2022-12-31 161468002 CHIAMPOU TRAVIS BESAW & KERSHNER LLP 45 BRYANT WOODS NORTH AMHERST NY 14228 990 2022-01-01 161514645 UNIVERSITY UROLOGY INC UNIV 7168592212 100 HIGH STREET MAIN BUILDING BUFFALO NY 14203 KENT CHEVLI MD PRESIDENT 7168592212 2023-09-18 1 KENT CHEVLI MD 999009999 0 EUGENE G KERSHNER P00601324 7166302400 2023-09-18 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z KENT CHEVLI MD 100 HIGH STREET MAIN BUILDING BUFFALO NY 14203 9589413 0 X N/A X 1997 NY UNIVERSITY UROLOGY, INC. IS ORGANIZED EXCLUSIVELY FOR THE PURPOSES OF SUPPORTING THE EDUCATIONAL MISSION OF THE JACOBS SCHOOL OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK AT BUFFALO (SCHOOL) BY PARTICIPATING IN THE PLAN FOR THE MANAGEMENT OF CLINICAL PRACTICE INCOME APPLICABLE TO THE SCHOOL, BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL MEDICAL SERVICES. 5 0 4 0 0 0 0 0 9009084 9582254 50 0 5829 7159 9014963 9589413 0 0 0 0 1104434 1150748 0 0 0 7896943 8478356 9001377 9629104 13586 -39691 263782 302458 126812 205179 136970 97279 X UNIVERSITY UROLOGY, INC. IS ORGANIZED EXCLUSIVELY FOR THE PURPOSES OF SUPPORTING THE EDUCATIONAL MISSION OF THE JACOBS SCHOOL OF MEDICINE AT THE STATE UNIVERSITY OF NEW YORK AT BUFFALO (SCHOOL) BY PARTICIPATING IN THE PLAN FOR THE MANAGEMENT OF CLINICAL PRACTICE INCOME APPLICABLE TO THE SCHOOL, BY PROVIDING CLINICAL INSTRUCTION AND SUPERVISION OF STUDENTS, INTERNS AND RESIDENTS AND, INCIDENT THERETO, RENDERING PROFESSIONAL MEDICAL SERVICES. 0 0 9483686 9589413 TO FOSTER ACADEMIC, RESEARCH AND CLINICAL PROGRAMS, RECRUIT AND RETAIN TEACHING PHYSICIANS, AND PROVIDE HEALTH CARE SERVICES IN THE FIELD OF UROLOGY. 9483686 1 0 0 0 0 0 0 0 0 0 0 0 0 1 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 4 0 1 4 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 0 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 NY X X THE ORGANIZATION 7168445610 3085 HARLEM ROAD SUITE 350 CHEEKTOWAGA NY 14225 TERESA DANFORTH MD VICE PRESIDENT 40.00 X X 616102 0 30500 KENT CHEVLI MD PRESIDENT 25.00 X X 300000 0 0 RICHARD GILBERT MD MEMBER 10.00 X 48000 0 0 JOHN RUTKOWSKI MD SECRETARY/TREASURER 10.00 X X 84000 0 0 CHRISTOPHER SKOMRA MD MEMBER 10.00 X 48000 0 0 1096102 0 30500 2 0 1 0 0 FEE FOR SERVICE 621110 8915155 8915155 GRADUATE MEDICAL EDUCA 621110 643514 643514 CONTRACT REVENUE 621110 23585 23585 9582254 MISCELLANEOUS INCOME 621110 7159 7159 7159 9589413 9589413 0 0 1096102 1034492 61610 4257 2031 2226 30500 30500 19889 19889 54442 54442 39540 19770 19770 6643 3322 3321 17732 14186 3546 5031 5031 24161 23658 503 CONTRACTUAL SERVICES 7360039 7360039 RESIDENTS EXPENSES 511553 511553 CAO'S FUND 445531 445531 BOOKS, DUE AND SUBSCRIP 13337 13337 347 347 9629104 9483686 145418 0 68204 156639 145609 102131 3241 3460 46728 40228 263782 302458 123593 151733 3219 53446 126812 205179 X 136970 97279 136970 97279 263782 302458 -39691 0 X X 0 1 X 1 0 X 94309 34548 128857 1607038 7601528 6126073 9009084 9582254 33925977 1607038 7601528 6220382 9043632 9582254 34054834 0 237130 39697 80454 57334 31411 446026 237130 39697 80454 57334 31411 446026 33608808 270 1732 1411 50 3463 270 1732 1411 50 3463 29763 20346 3599 5829 7159 66696 1637071 7623606 6225392 9049511 9589413 34124993 0.98490 0.97160 0.00010 0.00030 X 0 MALPRACTICE CAPITAL CONTRIBUTIONS 20716 PATIENT LIST 19512 40228 CAO FUND PAYABLE 53446 53446 9589413 0 9589413 0 9589413 9629104 0 9629104 0 9629104 0 0 0 0 0 0 0 0 0 TERESA DANFORTH MD VICE PRESIDENT 616102 0 0 0 0 0 30500 0 0 0 646602 0 0 0 KENT CHEVLI MD PRESIDENT 300000 0 0 0 0 0 0 0 0 0 300000 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 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 11B A COPY OF THE FORM 990 WAS GIVEN TO EACH BOARD MEMBER FOR REVIEW BEFORE THE 990 WAS FILED. THIS WAS DONE VIA REGULAR MAIL AND EMAIL. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES DISCLOSURE OF ANY CONFLICTS OF INTEREST ON AN ANNUAL BASIS. ALL EMPLOYEES AND MEMBERS OF THE ORGANIZATION ARE COVERED UNDER THE POLICY WHICH IS MONITORED BY SITE DIRECTORS. IF A CONFLICT IS FOUND, THE MATTER IS REVIEWED JOINTLY WITH LEGAL ADVICE BEING PROVIDED AS NEEDED. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMPENSATION IS GOVERNED BY ARTICLE XVI OF THE STATE UNIVERSITY OF NEW YORK. 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