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  5. UB FAMILY MEDICINE, INC.

UB FAMILY MEDICINE, INC.

Company Details

Name: UB FAMILY MEDICINE, INC.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 30 Jul 1986 (39 years ago)
Entity Number: 1101292
ZIP code: 14215
County: Erie
Place of Formation: New York
Address: ERIE COUNTY MEDICAL CENTER, 462 GRIDER STREET, BUFFALO, NY, United States, 14215
Principal Address: 462 GRIDER ST, BUFFALO, NY, United States, 14215

Contact Details

Phone +1 716-831-8612

Phone +1 716-859-5600

Phone +1 716-550-8361

Phone +1 716-710-4399

Phone +1 716-568-3600

Phone +1 716-835-9800

Phone +1 716-688-9641

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
PLWFFKP6TET1 2022-07-15 77 GOODELL ST STE 240, BUFFALO, NY, 14203, 1243, USA 77 GOODELL ST, BUFFALO, NY, 14203, 1243, USA

Business Information
Doing Business As UBMD FAMILY MEDICINE
Congressional District 26
State/Country of Incorporation NY, USA
Activation Date 2021-06-23
Initial Registration Date 2012-06-08
Entity Start Date 1969-01-01
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name CASEY SCHROEDER
Address 77 GOODELL ST, SUITE 240, BUFFALO, NY, 14203, 1243, USA
Title ALTERNATE POC
Name CASEY SCHROEDER
Address 77 GOODELL ST, SUITE 240, BUFFALO, NY, 14203, 1243, USA
Government Business
Title PRIMARY POC
Name CASEY SCHROEDER
Address 77 GOODELL ST, SUITE 240, BUFFALO, NY, 14203, 1243, USA
Title ALTERNATE POC
Name CASEY SCHROEDER
Address 77 GOODELL ST, SUITE 240, BUFFALO, NY, 14203, 1243, USA
Past Performance
Title PRIMARY POC
Name CASEY SCHROEDER
Address 77 GOODELL ST, SUITE 240, BUFFALO, NY, 14203, USA
Title ALTERNATE POC
Name HENRY MCWILLIAMS
Address 77 GOODWELL STREET, SUITE 240, BUFFALO, NY, 14203, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
UB FAMILY MEDICINE , INC. PENSION PLAN 2010 161280696 2011-08-31 UB FAMILY MEDICINE , INC. 114
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 7168984744
Plan sponsor’s address 462 GRIDER STREET, CC BUILDING, ROOM 160, BUFFALO, NY, 14215

Plan administrator’s name and address
Administrator’s EIN 161280696
Plan administrator’s name UB FAMILY MEDICINE , INC.
Plan administrator’s address 462 GRIDER STREET, CC BUILDING, ROOM 160, BUFFALO, NY, 14215
Administrator’s telephone number 7168984744

Signature of
Role Plan administrator
Date 2011-08-31
Name of individual signing MARY ELLEN ASHE
UB FAMILY MEDICINE, INC. 403(B) PLAN 2009 161280696 2010-10-07 UB FAMILY MEDICINE INC. 119
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-12-01
Business code 621111
Sponsor’s telephone number 7168984744
Plan sponsor’s address 462 GRIDER STREET, CC BUILDING ROOM 160, BUFFALO, NY, 14215

Plan administrator’s name and address
Administrator’s EIN 161280696
Plan administrator’s name UB FAMILY MEDICINE INC.
Plan administrator’s address 462 GRIDER STREET, CC BUILDING ROOM 160, BUFFALO, NY, 14215
Administrator’s telephone number 7168984744

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing MARY ELLEN ASHE
UB FAMILY MEDICINE , INC. PENSION PLAN 2009 161280696 2010-10-07 UB FAMILY MEDICINE , INC. 97
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 7168984744
Plan sponsor’s address 462 GRIDER STREET, CC BUILDING, ROOM 160, BUFFALO, NY, 14215

Plan administrator’s name and address
Administrator’s EIN 161280696
Plan administrator’s name UB FAMILY MEDICINE , INC.
Plan administrator’s address 462 GRIDER STREET, CC BUILDING, ROOM 160, BUFFALO, NY, 14215
Administrator’s telephone number 7168984744

Signature of
Role Plan administrator
Date 2010-10-07
Name of individual signing MARY ELLEN ASHE

Chief Executive Officer

Name Role Address
THOMAS C. ROSENTHAL, M.D. Chief Executive Officer 462 GRIDER STREET, BUFFALO, NY, United States, 14215

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent ERIE COUNTY MEDICAL CENTER, 462 GRIDER STREET, BUFFALO, NY, United States, 14215

History

Start date End date Type Value
1995-07-05 2000-10-03 Name FAMILY MEDICINE FACULTY ASSOCIATES, INC.
1995-07-05 2000-10-03 Address ERIE COUNTY MEDICAL CENTER, 462 GRIDER STREET, BUFFALO, NY, 14215, USA (Type of address: Service of Process)
1993-03-04 1993-08-17 Address 462 GRIDER ST, BUFFALO, NY, 14215, USA (Type of address: Chief Executive Officer)
1993-03-04 1995-07-05 Address 462 GRIDER ST, BUFFALO, NY, 14215, USA (Type of address: Service of Process)
1986-07-30 1995-07-05 Name FAMILY MEDICINE FACULTY ASSOCIATES, P.C.
1986-07-30 1993-03-04 Address 1001 HUMBOLDT PARKWAY, BUFFALO, NY, 14208, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
001003000383 2000-10-03 CERTIFICATE OF AMENDMENT 2000-10-03
950705000067 1995-07-05 CERTIFICATE OF REINCORPORATION 1995-07-05
930817002739 1993-08-17 BIENNIAL STATEMENT 1993-07-01
930304002356 1993-03-04 BIENNIAL STATEMENT 1992-07-01
B385891-6 1986-07-30 CERTIFICATE OF INCORPORATION 1986-07-30

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
16-1280696 Corporation Unconditional Exemption 77 GOODELL STREET, BUFFALO, NY, 14203-1243 1996-02
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Organization that normally receives no more than one-third of its support from gross investment income and unrelated business income and at the same time more than one-third of its support from contributions, fees, and gross receipts related to exempt purposes 509(a)(2)
Tax Period 2023-12
Asset 5,000,000 to 9,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 5675321
Income Amount 14258392
Form 990 Revenue Amount 14178948
National Taxonomy of Exempt Entities Health Care: Group Health Practice (Health Maintenance Organizations)
Sort Name ERIE COUNTY MEDICAL CENTER

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name UB FAMILY MEDICINE INC
EIN 16-1280696
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name UB FAMILY MEDICINE INC
EIN 16-1280696
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name UB FAMILY MEDICINE INC
EIN 16-1280696
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name UB FAMILY MEDICINE INC
EIN 16-1280696
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name UB FAMILY MEDICINE INC
EIN 16-1280696
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5214317100 2020-04-13 0296 PPP 77 Goodell Street Suite 240, BUFFALO, NY, 14203-1205
Loan Status Date 2021-03-02
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1383075
Loan Approval Amount (current) 1383075
Undisbursed Amount 0
Franchise Name -
Lender Location ID 46391
Servicing Lender Name Manufacturers and Traders Trust Company
Servicing Lender Address One M & T Plaza, 15th Fl, BUFFALO, NY, 14203
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Existing or more than 2 years old
Project Address BUFFALO, ERIE, NY, 14203-1205
Project Congressional District NY-26
Number of Employees 90
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 46391
Originating Lender Name Manufacturers and Traders Trust Company
Originating Lender Address BUFFALO, NY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 1390615.6
Forgiveness Paid Date 2020-11-03

Related by officers

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Related by address

ERIE COUNTY MEDICAL CENTER, 462 GRIDER STREET, BUFFALO, NY, United States, 14215

GRIDER COMMUNITY GARDENS LLC

462 GRIDER ST, BUFFALO, NY, United States, 14215

HMB 7 LLC BUFFALO INTERNAL MEDICINE ASSOCIATES, P.C. UNIVERSITY RADIOLOGY AT E.C.M.C., P.C.

Date of last update: 16 Mar 2025

Sources: New York Secretary of State

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